Citalopram

What are the benefits of taking citalopram?

Citalopram can prevent or reduce the unpleasant symptoms that happen with some mental health conditions like depression. This is important for good quality of life and to ensure that a pregnant woman remains well in preparation for caring for her baby.

Are there any risks of taking citalopram during pregnancy?

SSRIs are commonly taken during pregnancy without any problem. However, some studies have linked SSRIs to a higher chance of preterm delivery, or of having a baby with a low birth weight. It is unclear whether these effects are due to medication or whether they are due to the effects of underlying illness in the mother, and other factors.

In the past, SSRI use in early pregnancy was thought to slightly increase the chance of heart problems with the baby. However, more recent studies do not support this. Even if there is a small effect, most women taking an SSRI will have a baby with a normal heart.

Pregnant women taking an SSRI will usually be advised to have a hospital delivery. This is because:

• SSRIs can sometime cause short-term withdrawal symptoms in the newborn baby. Observation of your baby for a few days after birth may be needed.

• Rarely, SSRI use in pregnancy can cause a problem in the baby, where blood flow to the lungs is too high. This is called persistent pulmonary hypertension of the newborn (PPHN). Around one in every 300 babies whose mother takes an SSRI may develop PPHN. As a precaution, your baby will be checked for breathing problems by a midwife or paediatrician.

• Women taking an SSRI in the month before delivery may have a slightly higher risk of post-partum haemorrhage (abnormal blood loss following birth). A hospital delivery ensures that if this occurs, it can be treated quickly.

A large number of studies have assessed the learning and behaviour of children exposed in the womb to SSRIs:

• Some studies have suggested that up to three out of every 100 children born to women taking an SSRI may develop autism spectrum disorder (ASD). In comparison, around one in every 100 children in the background population is diagnosed with ASD. Other studies have found no links between SSRI exposure and ASD.

• Some (but not all) studies have found that children exposed in the womb to SSRIs showed differences in their thinking and learning.

• Some (but not all) studies have suggested that SSRI exposure may affect motor skills (movement), at least in the first few weeks of life.

Although some of this information may seem worrying, more research is required before we can say whether any differences in learning and behaviour are linked to SSRI use in pregnancy, to the mother’s underlying condition, or to a combination of both of these factors.

Untreated depression in pregnancy has been linked to differences in the child’s learning and behaviour. It is important that pregnant women with mental health problems, like depression, are treated for their own and their baby’s wellbeing.

Are there any alternatives to taking citalopram?

Possibly. Other medicines can be used to treat depression and panic disorder. Some mental health problems can also be treated with talking therapies instead of medicines. However, this does not work for everyone, and some people may prefer to take a medicine. If a woman’s condition is well-controlled with citalopram, it may be best to stay on it rather than try something new and risk a relapse.

Ideally, women planning a pregnancy should speak to their GP or specialist to decide whether citalopram is still the best option for them.

What if I prefer not to take medicines during pregnancy?

It is very important that mental health problems are treated to ensure a woman’s wellbeing during pregnancy and while looking after her baby. Stopping citalopram can put you at risk of relapse and stopping suddenly can cause you to experience withdrawal symptoms. Your doctor will only prescribe medicines when necessary and will be happy to talk to you about any concerns that you might have.

Women should not stop taking citalopram without first speaking to their midwife, GP or specialist.