Trazodone and Pregnancy: What the Research Shows
Trazodone is an antidepressant often prescribed off label at low doses for sleep. Studies so far have not linked it to birth defects or miscarriage, though there is less data than for SSRIs, so plan any change with your prescriber.
By Alena A. Kozlova · 2026-11-02 · 4 min read
Medical content reviewed by Dr. Jason Tan , Consultant Psychiatrist, on November 1, 2026.
Key takeaways Trazodone is often prescribed off label at low doses for sleep, including to women of childbearing age, so the pregnancy question is often about a sleep aid. Studies over several decades have not linked trazodone to major birth defects or miscarriage, the FDA label says. The largest study so far, ENTIS 2023, followed 221 pregnancies exposed early to trazodone and found no clear rise in birth defects, but its authors say more research is needed. Newborns exposed late in pregnancy may have short-lived symptoms, as with other antidepressants, though there is little data for trazodone itself. Don't stop trazodone suddenly; plan any change with your care team. On this page
How much pregnancy data exists for trazodone Is trazodone safe in pregnancy? What can untreated depression mean for you? Can you take trazodone for sleep while pregnant? What about newborns and breastfeeding? What should you ask your prescriber about trazodone and pregnancy? Trazodone is an antidepressant, but it is often prescribed off label, at low doses, for insomnia. So the question here is usually about a sleep medicine: what to do if you take it and find out you are pregnant, or plan to be. In short, what is known is reassuring, but there is less of it than for common antidepressants. Don't stop it suddenly, and talk to your prescriber; if you take it for sleep, ask about other options. Symptoms in newborns after use late in pregnancy are short-lived, and the birth team can watch for them.
How much pregnancy data exists for trazodone
Any medicine taken around the time a pregnancy starts is checked for a link with birth defects, and trazodone is often still being taken then, because many people take it nightly for sleep. The more pregnancies studied, the surer the answer, and for trazodone there are fewer than for common SSRIs. The largest study so far is ENTIS 2023, a multicentre study by teratology information services that followed 221 pregnancies exposed to trazodone early on and compared them with 869 exposed to SSRIs. It found no significant difference in major birth defects, 0.6% against 2.6%, though this rests on small numbers (1 of 169 babies on trazodone), and no significant rise in pregnancy loss or termination. Pregnancy loss was 25% on trazodone against 18% on SSRIs, a gap that wasn't statistically clear, and the comparison was with women on SSRIs, not on no medicine. The authors call it the largest study so far and say the results need confirming.
Medicine First-trimester data described by the source Trazodone 221 pregnancies in ENTIS 2023; over 300 across studies (MotherToBaby) Bupropion more than 2,000 pregnancies (MotherToBaby) Sertraline more than 25,000 pregnancies (MotherToBaby)
The table compares trazodone with two antidepressants that have more pregnancy data. Less data doesn't mean more risk. It means the estimate is less certain, which is worth weighing with your prescriber.
Is trazodone safe in pregnancy?
What is known so far is reassuring but limited. MotherToBaby says multiple studies found no increase in miscarriage, and that across over 300 first-trimester exposures birth defects were no more common than the background rate. The FDA label agrees and adds that the studies are small and have limits. On preterm birth the picture is mixed: one study found no higher chance of preterm birth or low birth weight, while another, of over 200 pregnancies, found a slightly higher chance of preterm delivery. Untreated depression or insomnia also carries risks, so the choice depends on how severe things are without treatment.
If you become pregnant on an antidepressant, do not stop it suddenly, and talk to your prescriber soon.
Stopping suddenly risks withdrawal and relapse at a time when both are harder to manage. The decision weighs the risks of the medication against the risks of untreated depression or anxiety. Both affect parent and baby, and for many people continuing treatment is the safer choice.
What can untreated depression mean for you?
If you take trazodone for depression, stopping can bring it back. In a study of 201 pregnant women with a history of depression who were well on an antidepressant, 68% of those who stopped it had depression come back during pregnancy, compared with 26% of those who kept taking it. Postnatal depression affects more than 1 in 10 mothers within a year of giving birth. In the UK and Ireland, suicide is the leading cause of death for women between six weeks and one year after the end of a pregnancy.
If you are having thoughts of suicide or of harming yourself, call or text 988 now, or call 911 if you are in danger. The National Maternal Mental Health Hotline, 1-833-TLC-MAMA (1-833-852-6262), is free and open 24/7 by call or text. In the UK, call NHS 111 and choose the mental health option, call 999 in an emergency, or call Samaritans on 116 123.
If you become pregnant on an antidepressant, do not stop it suddenly, and talk to your prescriber soon.
Stopping suddenly risks withdrawal and relapse at a time when both are harder to manage. The decision weighs the risks of the medication against the risks of untreated depression or anxiety. Both affect parent and baby, and for many people continuing treatment is the safer choice.
Can you take trazodone for sleep while pregnant?
This is a common situation: trazodone is often prescribed off label, at low doses, for insomnia. For sleep, the weighing is different, because sleep problems in pregnancy are common, and there are often ways to treat them without medication, such as cognitive behavioral therapy for insomnia (CBT-I). Ask your prescriber and obstetrician whether you still need it, at what dose, and what non-drug options for sleep fit you, and don't stop on your own if you have been taking it nightly for a while. How trazodone differs from other antidepressants, and why it is used for sleep, is on the trazodone overview .
What about newborns and breastfeeding?
Trazodone late in pregnancy may cause short-lived symptoms in newborns, as other antidepressants can, MotherToBaby says, though there is little data for trazodone itself; telling the birth team about it lets them watch for this. Trazodone passes into breast milk in small amounts, and data are limited; watch for extra sleepiness and tell your baby's doctor.
What should you ask your prescriber about trazodone and pregnancy?
Ask early, ideally before you try to conceive, and bring your obstetrician into the plan. It helps to ask or tell them:
What you take trazodone for: sleep, depression or both. Whether to stay on it, change the dose or switch. Non-drug options for sleep in pregnancy. How to stop gradually, if stopping is the plan. What the birth team and your baby's doctor should know. The label lists the National Pregnancy Registry for Antidepressants, which you can join.
Download on the App Store Sleep and mood can shift during pregnancy and after birth, and a daily record helps your care team see it. The withClaro app lets you log sleep, mood and side effects each day, linked to your dose, and turns it into a report for your prescriber.
Frequently asked questions What if I found out I was pregnant months into taking trazodone? Don't stop suddenly, and tell your prescriber and obstetrician soon. Early exposure is what the largest study looked at, and it found no clear rise in birth defects.
Does trazodone cause miscarriage? MotherToBaby says multiple studies found no increase. Ask your OB about your own risks.
Can I breastfeed on trazodone? It passes into milk in small amounts. Ask your prescriber and watch your baby for sleepiness.
Is trazodone safer than sleeping pills in pregnancy? There is no head-to-head evidence to say so. Ask your prescriber how the data for trazodone compare with the alternatives they are considering for you.
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Sources Dao et al., 2023, Journal of Clinical Psychopharmacology: Reproductive safety of trazodone after maternal exposure in early pregnancy, a comparative ENTIS cohort study MotherToBaby: Trazodone MotherToBaby: Bupropion MotherToBaby: Sertraline (Zoloft) TRAZODONE HYDROCHLORIDE tablets prescribing information, US Food and Drug Administration via DailyMed Cohen et al., 2006, JAMA: Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment NHS inform: Postnatal depression MBRRACE-UK: Saving Lives, Improving Mothers' Care 2026, lay summary (UK and Ireland, 2022 to 2024) Claro articles are for self-monitoring and educational purposes only. They are not a medical device, therapist, or diagnostic tool, and do not replace care from your prescribing clinician. If you are in crisis, contact your care team, emergency services, the Samaritans (UK: 116 123), or the Crisis Text Line (US: text HOME to 741741).