If you’re pregnant or planning to be, and you’re taking an antidepressant, you may be torn: Is it safer for my baby if I stop — or safer for both of us if I stay on? Many people quietly wrestle with this question, sometimes feeling guilt from both directions.


The reality is nuanced. Stopping antidepressants during pregnancy can sometimes go smoothly, but for others it leads to a significant return of depression or anxiety — which itself carries real risks for both parent and baby. This page walks through what current research (including insights highlighted by STAT’s Morning Rounds coverage) suggests happens when antidepressants are discontinued in pregnancy, and how to navigate this decision as safely and compassionately as possible.


The Core Dilemma: Medication Risk vs. Illness Risk

During pregnancy, every health decision feels amplified. With antidepressants, you’re balancing two kinds of risk:

  • Potential medication risks to the fetus and newborn (often small but understandably concerning).
  • Risks of untreated depression or anxiety to both the pregnant person and the developing baby.

For years, the conversation focused heavily on medication side effects in pregnancy. More recent work — including large observational studies and expert reviews — has clarified that:

  • Most commonly used SSRIs and SNRIs do not appear to cause major birth defects when used in pregnancy.
  • There may be small increased risks of issues like preterm birth, neonatal adaptation syndrome, or (less clearly) persistent pulmonary hypertension of the newborn (PPHN).
  • Moderate to severe untreated depression itself increases risks of preterm birth, low birth weight, poor prenatal care, substance use, and postpartum depression.

A Moment of Decision

Pregnant person sitting thoughtfully with a clinician reviewing medication options
Many pregnant people face difficult choices about whether to continue or discontinue antidepressants.

Conversations like the one pictured above are happening more often, as both clinicians and patients recognize that mental health is a central part of prenatal care.


What Actually Happens When Antidepressants Are Stopped in Pregnancy?

Research over the last two decades — including large cohort studies from the U.S. and Europe — has tried to answer a key question: If you stop antidepressants during pregnancy, how likely are you to relapse?

  1. Relapse risk is often substantial, especially for people with recurrent depression.
    Several studies have found:
    • Pregnant people with a strong history of depression who stop antidepressants can have relapse rates around 50–70%.
    • Those who continue medication often still have some risk, but significantly lower — sometimes closer to 25–30%, depending on severity and supports.
  2. Timing matters.
    Relapse often appears:
    • In the first trimester after abrupt discontinuation, or
    • Later in pregnancy if stress, sleep disruption, or relationship/financial pressures increase.
  3. How you stop matters.
    People who taper slowly with medical supervision generally:
    • Have fewer withdrawal (discontinuation) symptoms (e.g., dizziness, “brain zaps,” irritability).
    • Are more likely to distinguish between true relapse and temporary withdrawal effects.
“For women with recurrent or severe depression, discontinuing antidepressant treatment during pregnancy significantly increases the risk of relapse, which can have meaningful consequences for both mother and child.”

— Summary of findings from perinatal psychiatry experts (e.g., Center for Women’s Mental Health at Massachusetts General Hospital)


A Case Example: Two Different Paths

Names and details changed for privacy, but these stories reflect patterns clinicians commonly see.

Case 1: “L.” — Stopping Suddenly
L. had struggled with major depression since her teens. When she became pregnant, she stopped her SSRI “cold turkey” after reading alarming headlines about medications and birth defects. Within four weeks:

  • She developed intense irritability and insomnia.
  • Her appetite plummeted; she lost more weight than her obstetrician was comfortable with.
  • Her thoughts grew increasingly hopeless, and she began missing prenatal appointments.

Eventually, she restarted medication in the second trimester under the guidance of a perinatal psychiatrist. Symptoms improved, but it took time, and the months in between were extremely difficult for her and her family.

Case 2: “J.” — A Planned Taper with Backup Strategies
J. had one episode of mild to moderate depression in college, treated successfully with an SSRI plus therapy. She’d been stable for five years. Before trying to conceive, she met with her psychiatrist and obstetrician. Together, they:

  • Reviewed her history and current supports.
  • Created a slow taper plan over several months.
  • Set up regular psychotherapy sessions and added daily light exercise and sleep routines.
  • Scheduled “check-in” visits during each trimester.

J. did well off medication during pregnancy, with only brief periods of low mood that were managed with therapy and lifestyle supports. Her plan included a clear agreement: if symptoms worsened beyond a set threshold, she would restart medication without shame or delay.


Risks of Untreated Depression and Anxiety During Pregnancy

It’s natural to focus on potential side effects of antidepressants, but untreated depression and anxiety carry their own set of risks:

  • For the pregnant person:
    • Higher risk of poor nutrition, inadequate prenatal care, and substance use.
    • More sleep disruption, which can worsen mood and blood pressure.
    • Increased risk of self-harm or suicidal thoughts in severe cases.
    • Greater chance of severe postpartum depression or anxiety.
  • For the baby:
    • Higher rates of preterm birth and low birth weight in some studies.
    • Possible effects on stress regulation and bonding after birth.

Large observational studies suggest that when depression is well-managed — whether with antidepressants, therapy, lifestyle changes, or a combination — pregnancy outcomes are generally better than when depression is severe and untreated.

For further reading, see:


What We Know About Antidepressant Risks in Pregnancy

Evidence is strongest for SSRIs such as sertraline, fluoxetine, citalopram, and escitalopram, and for some SNRIs. The key findings from large population studies and meta-analyses include:

  • Major birth defects: Most SSRIs/SNRIs do not significantly increase overall risk of major congenital malformations. Some early concerns (e.g., with paroxetine and cardiac defects) led to closer monitoring and more cautious use.
  • Preterm birth and low birth weight: Slightly higher rates have been seen with antidepressant use, but similar increases are seen with untreated depression, making it hard to separate medication effects from illness effects.
  • Neonatal adaptation syndrome: Up to 20–30% of babies exposed to SSRIs late in pregnancy may have temporary symptoms (jitteriness, feeding difficulties, mild breathing issues) that usually resolve within days to a week.
  • PPHN: Some studies have suggested a small increased risk with late-pregnancy SSRI exposure, but the absolute risk remains low (often cited around 2–3 per 1,000 births versus 1–2 per 1,000 without exposure).
Pregnant person holding their belly while consulting information on a tablet
Understanding relative versus absolute risk can help put antidepressant safety data in perspective.

Before and After Discontinuation: What Can Change?

While every experience is unique, many people notice shifts in both mood and physical well-being when coming off antidepressants during pregnancy.

Symptoms can worsen or improve after stopping medication, depending on mental health history, supports, and how the change is managed.

Common changes after stopping antidepressants during pregnancy:

  • Mood: More frequent crying spells, increased anxiety, or return of depressive thoughts — or in some mild cases, little to no change.
  • Sleep: Trouble falling or staying asleep, which may be mistaken for “normal pregnancy insomnia.”
  • Energy and motivation: Fatigue, loss of interest in daily activities, or difficulty keeping up with work and relationships.
  • Physical sensations: Flu-like symptoms, dizziness, “electric shock” sensations (brain zaps), especially with abrupt discontinuation of certain SSRIs or SNRIs.

Distinguishing between withdrawal symptoms (usually peaking in days to a couple of weeks) and relapse (gradual return of core depressive or anxiety symptoms over weeks to months) can guide next steps.


Key Questions to Discuss With Your Clinician

If you’re considering stopping, continuing, or changing antidepressants during pregnancy, bring these questions to your obstetrician, psychiatrist, or primary care clinician:

  1. What is my personal relapse risk?
    Ask how your history (number of episodes, severity, past hospitalizations, suicide attempts) influences the likelihood of symptoms returning.
  2. Which medications have the best safety data in pregnancy?
    Sometimes switching to an SSRI with more pregnancy data (e.g., sertraline) may be discussed.
  3. If I taper, what schedule is safest?
    Work out a specific plan (dose reductions, timing, monitoring) rather than improvising.
  4. What non-medication supports can we add?
    Therapy (CBT, IPT), partner or family involvement, support groups, sleep and exercise plans.
  5. What are early warning signs that I should restart medication?
    Agree on concrete examples — e.g., persistent low mood, missing work, losing interest in the pregnancy, suicidal thoughts.
“The goal isn’t perfection; it’s a plan that keeps you as well as possible while minimizing avoidable risks.”

Practical Steps If You’re Thinking About Stopping Antidepressants

If you and your care team decide that discontinuing or reducing antidepressants makes sense, these steps can make the process safer and more manageable.

  1. Never stop suddenly without medical guidance.
    Abrupt withdrawal can cause intense symptoms that are hard to tell apart from relapse and can be destabilizing during pregnancy.
  2. Create a gradual taper plan.
    Depending on the medication and dose, tapers may last weeks to months. Your clinician may suggest:
    • Reducing the dose in small increments.
    • Pausing at each new dose for 1–2 weeks to see how you feel.
    • Adjusting the speed based on your symptoms.
  3. Schedule regular check-ins.
    Ideally, see or message your clinician:
    • Shortly after each dose reduction.
    • At least once per trimester, and more often if symptoms fluctuate.
  4. Involve your support network.
    Ask a partner, friend, or family member to watch for mood or behavior changes and speak up if they notice concerning signs.
  5. Strengthen non-drug coping strategies.
    Examples include:
    • Regular therapy (CBT, mindfulness-based therapy, or interpersonal therapy).
    • Daily light movement (e.g., walking), if medically cleared.
    • Sleep hygiene: consistent bedtime, limiting screens, short naps only.
    • Simple, balanced meals at regular intervals to stabilize energy.
  6. Have a “rescue plan.”
    Decide in advance what you’ll do if symptoms come back strongly — including when you would restart medication and how to access urgent support.
Pregnant person talking with a mental health professional via telehealth
Telehealth visits can make it easier to stay closely connected with mental health support throughout pregnancy.

Common Obstacles — and How to Navigate Them

Even with a good plan, people face real-world barriers when managing antidepressants during pregnancy.

  • Stigma and self-blame.
    Many pregnant people feel judged for taking medication, or for needing it at all.

    Reframe: Treating depression is an act of care for your baby. A healthier you is usually a healthier pregnancy.

  • Conflicting advice from different clinicians.
    You might hear “stop everything” from one provider and “never stop” from another.

    Strategy: Ask your clinicians to communicate directly or request referral to a perinatal psychiatrist or maternal-fetal medicine specialist.

  • Scary headlines and online forums.
    Stories online can be powerful but are often not representative or scientifically balanced.

    Strategy: Prioritize information from reputable sources (ACOG, academic centers, national health organizations). Bring any worries you see online to your appointments.

  • Access to mental health care.
    Therapy and perinatal psychiatry can be hard to find or afford.

    Strategy: Ask about telehealth, group programs, sliding-scale clinics, or resources through your insurance, community health centers, or employer.


Looking Beyond Pregnancy: Postpartum Considerations

The story doesn’t end at delivery. The postpartum period is a time of:

  • Huge hormonal shifts.
  • Sleep deprivation.
  • New role demands and identity changes.

People with a history of depression or anxiety — especially if they stopped antidepressants during pregnancy — are at higher risk of postpartum depression and anxiety.

Questions to explore before birth:

  • Will you restart or adjust medication soon after delivery?
  • How does medication choice interact with plans to breastfeed?
  • Who will help you monitor your mood in the first 3–6 months postpartum?
Parent holding a newborn baby, appearing calm and supported
Planning ahead for postpartum mental health can reduce the risk and impact of postpartum depression and anxiety.

Putting It All Together: A Balanced View

When pregnant people discontinue antidepressants, outcomes vary widely. The evidence to date suggests:

  • Relapse is common in those with moderate to severe or recurrent depression who stop medication, particularly without a careful plan.
  • Most modern antidepressants have reassuring — though not perfect — safety data in pregnancy, with major malformations unlikely but some small increases in other risks.
  • Untreated depression and anxiety carry real risks for both parent and baby, which should be weighed alongside medication risks.
  • Shared decision-making with clinicians who understand perinatal mental health is crucial.

You do not have to figure this out alone, and there is no moral “right” or “wrong” answer — only the plan that best supports your safety and your baby’s well-being.


Next Steps: How to Advocate for Yourself

If this topic is weighing on you, here are some concrete steps you can take this week:

  1. Make an appointment with your prescribing clinician and your obstetric provider to talk specifically about mood and medications.
  2. Write down your history with depression or anxiety, including what has helped and what hasn’t.
  3. Bring questions about medication risks, relapse risks, and postpartum planning — and ask for written information or reputable links.
  4. Identify at least one person in your life who can check in on your mood regularly during pregnancy and after birth.
  5. If you can, connect with a perinatal mental health specialist or therapist experienced in pregnancy and postpartum care.

Your mental health is not a side note to your pregnancy; it’s a central part of it. Taking the time to craft a thoughtful plan — whether that involves continuing, adjusting, or carefully discontinuing antidepressants — is a meaningful investment in both your future and your baby’s.