Tricyclic antidepressants during pregnancy

Amantadine is used cautiously in patients with seizure disorders, psychiatric problems, renal impairment, and cardiac disease. Amantadine is a Pregnancy Category B drug and is used cautiously during pregnancy and lactation. Concurrent use of antihistamines, phenothiazines, tricyclic antidepressants, disopyramide, and quinidine may increase the anticholinergic effects (dry mouth, blurred vision, constipation) of amantadine... 

When tricyclic antidepressants are withdrawn during pregnancy, they should be tapered gradually to avoid withdrawal symptoms. If possible, drug tapering is usually begun 5 to 10 days before the estimated date of confinement. 

Nortriptyline and desipramine may be the tricyclic antidepressants (TCAs) of choice, given their extensive assessment during pregnancy and well-known therapeutic concentrations, which should be monitored. 

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