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Mirtazapine, sold under the brand name Remeron among others, is an atypical tetracyclic antidepressant, and as such is used primarily to treat depression. [11] [12] Its effects may take up to four weeks but can also manifest as early as one to two weeks.
Women should speak to their doctor or healthcare professional before starting or stopping any medications while pregnant. [1] Drugs taken in pregnancy including over-the counter-medications, prescription medications, nutritional supplements, recreational drugs, and illicit drugs may cause harm to the mother or the unborn child.
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Vortioxetine at 5 mg/day may produce antidepressant effects and result in SERT occupancy as low as 50%. [ 13 ] [ 46 ] [ 49 ] This is in apparent contrast to SSRIs and SNRIs, which appear to require a minimum of 70 to 80% occupancy for antidepressant efficacy.
The National Institute for Clinical and Health Excellence recommends (as of September 2013) that duloxetine not be routinely offered as first-line treatment, and that it only be offered as second-line therapy in women wishing to avoid therapy. The guideline further states that women should be counseled regarding the drug's side effects. [52]
Citalopram, sold under the brand name Celexa among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. [7] [10] It is used to treat major depressive disorder, obsessive compulsive disorder, panic disorder, and social phobia. [7] The antidepressant effects may take one to four weeks to occur. [7]
Antidepressant exposure (including escitalopram) is associated with shorter duration of pregnancy (by three days), increased risk of preterm delivery (by 55%), lower birth weight (by 75 g), and lower Apgar scores (by <0.4 points). Antidepressant exposure is not associated with an increased risk of spontaneous abortion. [55]
Use of antidepressants during pregnancy may result in fetus abnormalities affecting functional development of the brain and behavior. [90] Studies have shown correlations between pregnant women treated with SNRIs and risk of hypertensive disorders, [91] preeclampsia, [92] miscarriage, [93] seizures in children, [94] and many other adverse affects.
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