Is It Safe to Take Amitriptyline in Pregnancy?

Amitriptyline is an antidepressant medication that is part of the class of drugs called tricyclics, and it can effectively treat mood disorders and migraine headaches in some patients. Like many medications, taking amitriptyline in pregnancy can carry certain risks. Discontinuing this medication may also result in risk, so a doctor or medical professional should always be consulted before making a decision regarding its use while pregnant.

Studies have shown that taking amitriptyline in pregnancy can cause harm to the fetus, but most governmental agencies do not have specific regulations regarding its use during pregnancy. Animal studies have shown that this medication leads to an increased chance of congenital malformations, or birth defects. Depending on the study, various dosages have stated this drug to be eight to 33 times more likely to lead to birth defects in newborns compared to a placebo. Animals can respond differently to some medications than humans, however.

Formal studies on mothers taking amitriptyline in pregnancy have not been performed, but there is still some evidence to suggest that it can carry significant risks. Anecdotal evidence report that birth defects such as missing limbs are possible in infants whose mothers took this drug while pregnant. Effects on the brain, such as delays in development and maturity have been reported occasionally, as well.

Other case studies have suggested dangers from taking amitriptyline in pregnancy that do not involve birth defects. Some reports state that newborn infants can demonstrate withdrawal symptoms after birth. These effects are possible due to the infant becoming accustomed to certain levels of amitriptyline while still in the womb. It is unknown to what extent withdrawal syndrome could lead to long-term mental or physical impairment, however.

Even after birth, the breast-feeding period can carry certain dangers for mothers taking amitriptyline. This medication may be passed into breast milk, at least in low levels. No solid research exists regarding the dangers of amitriptyline in breast milk, but a United States agency, the Food and Drug Administration, has said that its effects could potentially be of concern.

Women that are of child-bearing age, particularly those that are considering becoming pregnant, should consult a doctor or medical professional before taking amitriptyline in pregnancy. It is important for patients to weigh the risks and benefits of this use during pregnancy. Depending on the situation, the medication may be continued, but at a lower dose. Alternately, switching to a different medication for the duration of the pregnancy and breast-feeding period may be recommended.