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Nortriptyline and Pregnancy

There are some situations where it may not be safe to take nortriptyline, and pregnancy is one of them. Although the FDA has not given nortriptyline a pregnancy risk classification, there have been a few reports of birth defects. Because of the unknown risks to the fetus, healthcare providers generally recommend newer antidepressants for pregnant women. However, your healthcare provider may recommend that you take nortriptyline during pregnancy if the benefits outweigh the risks.

 

Is Nortriptyline During Pregnancy Safe? -- An Overview

For women who are pregnant, nortriptyline hydrochloride (Pamelor®) may not be safe. This is based on animal studies that looked at the effects of nortriptyline during pregnancy and a few reports of birth defects in humans.
 

Nortriptyline and Pregnancy Risk

The U.
 S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. However, the FDA has not given nortriptyline a pregnancy risk classification, likely because there is very little information about using nortriptyline during pregnancy. However, other sources have suggested that the risk to the fetus due to nortriptyline is low. There have been a few reports of birth defects (including problems with arms or legs), although it does not seem that these problems were caused by nortriptyline.
 
Most healthcare providers recommend using newer antidepressants, which have been more thoroughly studied in pregnancy. However, your healthcare provider may recommend that you take nortriptyline during pregnancy if the benefits to you and the fetus outweigh the risks to the fetus. In fact, recent studies have suggested that not treating depression in the mother may actually be more harmful to a baby than exposure to antidepressants.
 
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;