Depression: treatment during pregnancy

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Signposting evidence-based information on the treatment of depression in pregnancy

Condition management

It is important to complete an individual risk assessment for your patient and to apply the principles of prescribing during pregnancy when looking at the available information and making treatment decisions. Check to see if a risk assessment has already been completed by the specialist team.

Untreated or inadequately treated depression can have adverse effects on the mother and therefore on the foetus.

Guidelines

NICE and CKS provide good information including the selection of therapies in order of preference based on evidence.

The information considers three scenarios:

You should check if there is local guidance for you to use in your area.

Pregnancy outcome information

UK Teratology Information Service (UKTIS) provides more detailed information on pregnancy outcomes for all the common individual antidepressants.

There is also an overview of the use of serotonin reuptake inhibitors (SSRIs) in pregnancy.

Patient information

Each of the UKTIS summaries has corresponding Best Use of Medicines in Pregnancy (BUMPS) patient information.

NHS Medicines A-Z provides a summary statement on the use in pregnancy of specific antidepressants such as citalopram, escitalopram, sertraline and venlafaxine

Support for prescribing decisions in people on interacting medicines, those with swallowing difficulties, renal impairment, or who are pregnant or breastfeeding
SPS protocol templates for the supply and administration of omeprazole for pre planned caesarean section by registered midwives.
SPS PGD template for administering subcutaneous terbutaline sulfate for the reduction of contraction frequency in individuals in labour.
SPS PGD template for the intrapartum administration of benzylpenicillin for prevention of early-onset Group B Streptococcus (GBS) infection in neonates.
Opioid analgesics may be used at any stage of pregnancy at the lowest effective dose for the short-term relief of pain when other analgesics are not effective.
Intramuscular hydroxocobalamin is the preferred treatment choice for management of clinically relevant vitamin B12 deficiency, including during pregnancy.
SPS PGD template for the supply of folic acid 5mg tablets to reduce risk of neural tube defect or compensate for increased folate demand during pregnancy.
SPS PGD template for the supply of aspirin tablets to individuals at risk of pre-eclampsia during pregnancy.
Signposting evidence-based information on the treatment of pain in pregnancy
Signposting evidence-based information on the treatment of urinary tract infection in pregnancy

Update history

  1. Removed link to the NICE pathway flowchart of pharmacological options as no longer on NICE website.
  1. Published

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