Does Celexa cross the placenta? (+3 management)

In this article, we will discuss Celexa and its effects during pregnancy and fetal development. We will discuss whether Clexa can cross the placenta or not. We will also ponder over the safe uses of Celexa during pregnancy. 

Does Celexa cross the placenta?

Yes, Celexa can cross the placenta. Celexa, an SSRI antidepressant can freely cross the placental barrier during pregnancy and cause profound effects on fetal development. 

If you are prescribed an SSRI antidepressant i.e. Celexa during pregnancy to combat depressive symptoms, then careful monitoring is required to prevent Celexa from entering the placenta and affecting fetal development. 

What does research suggest?

It is studied that about 20% of pregnant women face depression for which they are mostly prescribed SSRI antidepressants. Based on the mechanism of SSRIs, they can freely cross the placental barrier and affect the serotonin homeostasis in the fetoplacental unit (1).

This imbalance in serotonin homeostasis affects fetal development and compromises placental functions. Due to this, the use of antidepressants in pregnant women remains controversial (1). 

Serotonin is a crucial neuromodulator and developmental chemical in the central nervous system serving its function in regulating neuronal cell proliferation, migration, and proper brain development (1). 

Taking SSRI antidepressants for depression during pregnancy may alter the serotonin levels in the mother and fetus. These drugs inhibit the reuptake of serotonin in the pre-synaptic terminal and alter serotonin levels in the brain (2). 

Alterations in fetal brain serotonin levels are associated with negative neuronal outcomes for other body systems as well such as the heart, lungs, and gastrointestinal system of the fetus (1).

Therefore, fetal serotonin levels should be strictly controlled throughout gestation as it is crucial for maintaining ideal in-utero conditions for proper fetal development and growth (1). 

Can Celexa affect the fetal development?

Celexa can affect fetal development as it is an FDA pregnancy risk category-C drug. This indicates that Celexa does not provide satisfactory studies in pregnant women and is a controversial drug to be taken during pregnancy (3). 

Some studies have reported that taking Celexa during the entire pregnancy may increase the chances of preterm birth and low birth weight. It is very rarely reported that during the second trimester, babies might develop a serious lung condition called persistent pulmonary hypertension (4).  

However, it should only be prescribed to you if this medication outweighs the benefits over risks to the fetus and the mother. Do not abruptly stop taking the medication as it may cause withdrawal, rather consult your doctor for alternative medication (4). 

How to manage the safe use of Celexa during pregnancy?

If your healthcare provider has prescribed Celexa to combat depression or related symptoms during pregnancy, then you should follow the instructions and take your dosage regularly as prescribed. 

However, careful monitoring of the mother and fetus’s health is a crucial step in antidepressive therapy during pregnancy. If you face discomfort or side effects, do not immediately stop the medication rather seek medical help. 

Your doctor must alter your dosage strength or frequency to avoid side effects or may prescribe an alternative drug regimen to tackle depression associated with pregnancy. 

Selection criteria for antidepressants during pregnancy 

Depression is a common occurrence in pregnant women. Therefore, SSRI antidepressants are the regular drug choices for pregnant females to combat depression during pregnancy (5). 

However, SSRI antidepressants such as Zoloft, Celexa, and others are commonly associated with crossing the placental barrier and causing fetal developmental conditions in pregnant females for which careful monitoring is required. 

Since depressive conditions are common in pregnancy, therefore, they can not be avoided and need proper treatment. Various factors serve as the basis for the selection of a suitable choice of antidepressant drug during pregnancy, which include (5): 

  • Past maternal response to drugs
  • Fetal exposure
  • Fetal toxicity
  • Potential side effects
  • Individual patient preference
  • Medication relapse

Your healthcare provider should consider these factors before prescribing the antidepressant drug treatment and should ensure its safe use for both the fetus and the mother. 


In the given article, we have discussed the possibilities of using Celexa during pregnancy. We have discussed its potential effects on fetal development and growth. Furthermore, we have discovered some antidepressant drug selection criteria for safe use during pregnancy. 

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Horackova H, Karahoda R, Cerveny L, Vachalova V, Ebner R, Abad C, Staud F. Effect of Selected Antidepressants on Placental Homeostasis of Serotonin: Maternal and Fetal Perspectives. Pharmaceutics. 2021 Aug 20;13(8):1306. doi: 10.3390/pharmaceutics13081306. PMID: 34452265; PMCID: PMC8397948.


Ewing G, Tatarchuk Y, Appleby D, Schwartz N, Kim D. Placental transfer of antidepressant medications: implications for postnatal adaptation syndrome. Clin Pharmacokinet. 2015 Apr;54(4):359-70. doi: 10.1007/s40262-014-0233-3. PMID: 25711391; PMCID: PMC4566926.


Leek JC, Arif H. Pregnancy Medications. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Citalopram | Escitalopram (Celexa® | Lexapro®) 2023 Jan. Available from:


Ewing G, Tatarchuk Y, Appleby D, Schwartz N, Kim D. Placental transfer of antidepressant medications: implications for postnatal adaptation syndrome. Clin Pharmacokinet. 2015 Apr;54(4):359-70. doi: 10.1007/s40262-014-0233-3. PMID: 25711391; PMCID: PMC4566926.

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