Which SSRI is contraindicated during pregnancy?

Paroxetine is considered contraindicated during pregnancy primarily due to its association with an increased risk of congenital malformations, particularly cardiac defects, when taken in the first trimester. Studies have shown that exposure to paroxetine during this critical period can lead to significant risks for the developing fetus, which has led to recommendations against its use in pregnant individuals unless absolutely necessary.

In contrast, other SSRIs such as fluoxetine, sertraline, and escitalopram are generally deemed safer options during pregnancy. While these medications are not without risks, the evidence surrounding them is less alarming compared to that associated with paroxetine. This risk-benefit analysis is crucial in guiding prescribing practices for pregnant patients with psychiatric conditions. Therefore, clinicians often lean towards using alternatives that have a more favorable safety profile in this population.