Fluoxetine during pregnancy

Fluoxetine is one of the best studied drugs during pregnancy. It is indicated in the treatment of depression and belongs to the group of serotonin re-uptake inhibitors (SSRIs), since it has the ability to increase the levels of this neurotransmitter, which is key in maintaining the balance of our mood.

Fluoxetine, under the brand Prozac, was the first drug marketed in the United States by the company Eli Lilly in 1988 for the treatment of major depression. He inspired a lot of confidence in the medical community, since It had the same efficacy as existing antidepressant drugs and also had fewer adverse effects.

Today, new molecules have been developed for the treatment of depressive disorders, although Fluoxetine has been the most used worldwide. Next, we detail its use during the pregnancy period.

Depression in pregnancy or prenatal depression

Pregnancy is a stage that marks the life of women. The hormonal sway that takes place in the body can trigger various types of emotions and feelings, sometimes opposed.

When the feeling of sadness persists over time, it may be the case that there is a picture of prenatal depression, a complex state to which we must pay special attention.

The hormonal swaying that takes place in the body of the pregnant woman can affect prenatal depression.

This is a complicated problem to detect, since Normal signs of pregnancy itself can be confused, such as fatigue, reluctance or difficulty falling asleep. If the following symptoms appear, we should ask for professional help:

  • Sadness and episodes of disconsolate crying for no apparent reason.
  • Impossibility to enjoy activities that you used to like.
  • Irritation and bad mood.
  • Feeling of emptiness and guilt.
  • Loss of social skills.
  • Anxiety.
  • Pessimistic thoughts for the future.
  • Difficulty maintaining concentration
  • Changes in eating, rest and hygiene habits.

Also the future mother can show ambiguous feelings towards the baby and even rejection of the idea of ​​having to face the delivery.

Untreated prenatal depression can bring significant side effects for the mother and the baby, as well as increased risk of spontaneous abortion, premature delivery, low birth weight or delayed growth of the baby.

In addition, suffering from prenatal depression increases the chances of suffering depression after childbirth by 25%. The benefits and risks of taking antidepressants during pregnancy must be taken into account. Here we tell you what you should know.

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Can I take fluoxetine during pregnancy?

Fluoxetine is the drug generally prescribed for the treatment of prenatal depression and although the FDA classifies it as category C, It has been considered a safe therapy for pregnant women suffering from depression always evaluating the risk / benefit of the treatment.

However, according to scientific literature, treatment with fluoxetine during the first trimester of pregnancy may be associated with an increased risk of cardiovascular malforamaciones in the baby

The data suggest that the risk of the newborn suffering a cardiovascular defect after maternal exposure to fluoxetine is of the order of 2/100 compared to an expected rate for these defects in the general population of approximately 1/100.

Other epidemiological studies suggest that the use of SSRIs in the final stage of pregnancy may increase the risk of persistent pulmonary hypertension in the newborn (HPPN).

The observed risk was approximately 5 cases per 1,000 pregnancies. In the general population, 1 or 2 cases of PNPH occur per 1,000 births.

Fluoxetine during pregnancy should only be used when the clinical situation of the future mother merits it, as it carries significant risks to the fetus.

According to the AEMPS, Fluoxetine should not be used during pregnancy unless the clinical situation of the woman requires this treatment and the potential risk to the fetus is justified.

It is especially important that the discontinuation of fluoxetine treatment is not abrupt, if not proceeding to a gradual reduction of the dose over a period of one to two weeks, to avoid the appearance of withdrawal symptoms.

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Also, if fluoxetine is used during pregnancy, Caution should be taken at the last stage or just before delivery. This is because some effects have been reported in newborns, such as:

  • Irritability
  • Tremor
  • Hypotonia
  • Persistent crying
  • Difficulty breastfeeding or sleeping


Treatment with fluoxetine during pregnancy, both in the first and the last stage, should be evaluated with the psychiatrist. The professional should evaluate the risk / benefit for both the future mother and the baby.

Therefore, if we are faced with a significant depression, You can consider keeping the treatment. However, if it is a well-controlled depression, the ideal is to do without fluoxetine treatment and have psychological support.