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Tricyclic Antidepressants and Pregnancy

Based on animal and human studies involving tricyclic antidepressants and pregnancy, it may not be safe to take the medication during pregnancy. Because many of the tricyclic antidepressants are older medications, the FDA has never given a pregnancy risk category to most of the tricyclic antidepressants. However, some of these medications did appear to cause harm to the fetus in animal studies.

 

Are Tricyclic Antidepressants Safe During Pregnancy? -- An Overview

For women who are pregnant, tricyclic antidepressants may not be safe. This is based on human and animal studies that looked at the effects of tricyclic antidepressants (TCAs) during pregnancy.
 

Tricyclic Antidepressants and Pregnancy Risk Categories

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. Most of the tricyclic antidepressants were never given a pregnancy risk category by the FDA, as is common with older medications. The few tricyclic antidepressants that were classified were given a pregnancy risk Category B or C rating.
 
Pregnancy Category B is given to medicines that are probably safe in humans (they did not cause problems in pregnant animals), although adequate human studies have not been performed. Pregnancy Category C is given to medicines that have not been studied in pregnant humans, but do appear to cause harm to the fetus in animal studies.
 

Recommendations for Using Tricyclic Antidepressants During Pregnancy

If you are pregnant or thinking about becoming pregnant, let your healthcare provider know.
 Your healthcare provider will consider both the benefits and risks of taking tricyclic antidepressants during pregnancy before making a recommendation for your particular situation.
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;