Psychiatric Medication in Pregnancy: What You Actually Need to Know

About Dr. Turner

Jessica Turner, MD, is a Brown University-trained psychiatrist specializing in the unique mental health challenges adults experience during the high-demand parenting years. With a focus on early childhood through adolescence, Dr. Turner helps parents navigate sleep disruption, cognitive overload, and the identity shifts that often accompany modern parenthood. As a parent herself, she understands the "mismatch" between daily demands and personal capacity, tailoring her Florida-based practice to support those who need to function at a high level under sustained stress. She offers both in-person and telehealth consultations at www.JessicaTurnerMD.com

By Jessica Turner, MD

In my concierge psychiatry practice, I commonly work with women who are excited about starting or growing their family, but understandably nervous about how their mental health will be managed during pregnancy. In a world full of information at our fingertips, between Google, AI, and social media, it's easy to end up with conflicting and confusing advice about medications. If you've struggled with a mental health concern like depression, anxiety, or ADHD, it's completely natural to wonder whether your current medications can be continued during pregnancy.

At first glance, it seems simple to ask, "Is this medication safe for my baby?" But that question, on its own, isn't quite the right one. Every medication you take comes with both a set of benefits and a set of potential risks. Pregnancy doesn't remove that equation, it just adds another variable to it. So let's look at what we actually know.

Untreated psychiatric illness during pregnancy carries real risks, to both the mother and the baby. This isn't a question of choosing who matters more. Both need to be considered together.

Suddenly stopping a medication can be genuinely dangerous, both mentally and physically. So please don't make this decision out of fear or on your own. If you discover you're pregnant, talk with your physician before stopping or decreasing any medication. Stopping cold turkey can lead to dangerous withdrawal symptoms and a relapse of the very symptoms the medication was treating in the first place.

The wellbeing of your baby is also an important part of this conversation. Untreated maternal mental illness has been associated with preterm birth and low birth weight. So the real question isn't "is this medication risky?";  it's whether the benefits of continuing a medication outweigh its potential risks, compared to the risks of leaving an illness untreated.

When you meet with a psychiatrist about this, they'll take a history of your mental health and your current stability on your medications. They'll walk you through the safety profile of your current or considered medications so you can make a collaborative, informed decision together. Good questions to bring to that conversation include: "Will this medication make it harder for me to get pregnant?" and "Will this medication increase the risk of miscarriage or birth defects?"

Fortunately, many of the medications commonly prescribed for mental health such as SSRIs like Zoloft and Prozac, for example, can be continued for most women during pregnancy. Many of these medications actually have quite favorable safety profiles for fertility and pregnancy planning. When women come to see me for preconception counseling, I'm able to share that very few medications are truly unsafe during pregnancy. In most cases, we can find a path forward that continues to support your mental health while keeping both you and your baby healthy.

This is also why psychiatric care and therapy work so well together during this season. While medication management addresses the biological piece, therapy offers space to process the emotional and identity shifts that come with pregnancy and new parenthood. Together they often provide more complete support than either alone.

A helpful resource if you want to read more about a specific medications during pregnancy is MotherToBaby.

Planning a family can be an exciting time, but it can also be a stressful one. If you're currently on medication, or thinking about starting a family while managing your mental health, I'd encourage you to consult a psychiatrist who can help you think through what's right for your unique situation.

Sources & Further Reading

·       Jarde A, Morais M, Kingston D, et al. Neonatal Outcomes in Women With Untreated Antenatal Depression Compared With Women Without Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2016;73(8):826-837.

·       Massachusetts General Hospital Center for Women's Mental Health (womensmentalhealth.org)

·       MotherToBaby (mothertobaby.org)