Use in Pregnancy: For escitalopram, only limited clinical data are available regarding exposures in pregnancy. Escitalopram should not be used during pregnancy unless clearly necessary and only after careful consideration of the risk/benefit ratio.
In reproductive toxicity studies performed in rats with escitalopram, embryo-fetotoxic effects were observed, but no increased incidence of malformations. Using SSRIs in the 3rd trimester may result in effects, including neurobehavioral disturbances in the newborn infant.
The following effects were reported in neonates with SSRIs administered to pregnant women until date of birth: Irritability, tremor, hypertonia, increased muscle tone, constant crying, difficulty in suckling or in sleeping.
They may either indicate serotonergic effects or withdrawal syndrome. If used during pregnancy, SSRIs should never be stopped abruptly.
Use in Lactation: It is expected that escitalopram will be excreted into human milk, and breastfeeding is not recommended during treatment.