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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ChristinaG on October 23, 2000, at 16:21:35
I just found out that I am pregnant and I am taking Effexor 150mg. My doctor has advised me to stay on the medicine because of the severity of my depression. I am scared of the effects that this might have on my unborn child. I also know what bad withdrawl symptoms this medicine can have. If anyone knows what effects this might have on my child or any other suggestions please help.
Posted by Racer on October 24, 2000, at 2:36:47
In reply to Effexor and pregnancy, posted by ChristinaG on October 23, 2000, at 16:21:35
Check back through the archives, since we just discussed this.
I seem to remember a study showing that while lab rats born to mothers on Effexor were lower in birth weight, they caught up within weeks and showed no other developmental delays. That's rats, but it sounds promising, right?
Congratulations, btw. Have a nice baby!
Posted by noa on October 24, 2000, at 6:47:16
In reply to Re: Effexor and pregnancy, posted by Racer on October 24, 2000, at 2:36:47
Also, look into the book--When Words are Not Enough--see the Read! page (link above)--which deals with women and depression, and has a chapter on pregnancy and lactation. Also, there is a link on Dr. Bob's links page to a web site on pregnancy and lactation.
Posted by tenuous on October 24, 2000, at 14:06:52
In reply to Re: Effexor and pregnancy, posted by noa on October 24, 2000, at 6:47:16
Here's the address for the abstract about the research study:
This is a quote from the abstract:
"Both doses of fluoxetine or venlafaxine reduced the body weight of litters; however, the body weight of litters from treated dams was equal to the weight of control litters by the time of weaning. At weaning there was no significant difference in weight between sexes. There was no difference among groups in number of live pups at birth, stillbirths, mortality during the lactation period or in the manifestation of serotonergic syndrome in adult rats. The occurrence of low birth weight among pups born to dams which did not show reduced food ingestion or reduction of body weight gain during treatment with lower doses of fluoxetine or venlafaxine suggests that these drugs may have a deleterious effect on prenatal development when administered during pregnancy. In addition, fluoxetine slightly but significantly affected the duration of pregnancy (about half a day), an effect not observed in the venlafaxine treated groups."
You should be fine. Good luck with the new baby!
Posted by Sunnely on October 25, 2000, at 0:02:06
In reply to Effexor and pregnancy, posted by ChristinaG on October 23, 2000, at 16:21:35
Dear Christina,
ANTIDEPRESSANTS APPEAR SAFE DURING PREGNANCY:
Women who use antidepressants during pregnancy are not significantly increasing the risk of congenital malformations (birth defects) in their infants, according to results of a large prospective study.
Dr. A. Ericson of the Centre for Epidemiology in Stockholm and colleagues followed 969 women who reported antidepressant use at a prenatal visit around weeks 10-12. There were 980 births, including 11 sets of twins.
The incidence of birth defects was 4%, and the incidence of infant mortality was 0.7% - no different from the rates in the general population.
The data came from the Swedish Medical Birth Registry, which includes information from prenatal visits, delivery, and the first pediatric examination.
Five hundred thirty-one women used SSRIs alone during pregnancy, 15 used SSRIs in combination with another antidepressant, and 423 used a non-SSRI antidepressant alone. The SSRIs used were citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). The non-SSRIs used were amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), lofepramine, nortriptyline (Pamelor), maprotiline (Ludiomil), mianserin, moclobemide (Manerix), trimipramine (Surmontil), and venlafaxine (Effexor).
Citalopram, for which no previous data on congential malformation effects exist, was the most popular antidepressant and was used by 39% of the women. Congenital anomalies did not appear more frequently in the infants of these women than in infants exposed to other SSRIs.
Over 40% of the women reported using other medications during pregnancy, including other psychotropics, analgesics, anti-asthmatic drugs, antibiotics, anti-inflammatory drugs, sex hormones, thyroid hormones, anti-epileptics, and insulin. There was no correlation between use of other medications and use of any class of antidepressant. (Readers should be aware, however, that this was an uncontrolled study.)
Dr. Zachary Stowe, Director of the Pregnancy and Postpartum Mood Disorder Program at Emory University, commenting on the above study, agreed with the suggestion of Dr. Ericson and colleagues that untreated depression can expose the mother and the child to risks associated with substance abuse, poor nutrition, and suicidal tendencies. He stated, "If they have a history of being able to come off (their antidepressant) and be OK, then do it. But if you take them off the medication and they get sick and need to go back on it, you're exposing the fetus both to antidepressant and to untreated depression." In his view, this is the worst of both worlds.
In a recent multicenter prospective study by Dr. Stowe, 112 women were taking antidepressants when they became pregnant, and all discontinued medication as soon as they discovered their pregnancy. Around 70% of them developed depressive symptoms in the course of pregnancy, and by the time their babies were born, 50% had started taking antidepressant again.
Even if a woman is able to stay off her antidepressant for the duration of pregnancy, it may not help that much. Most women don't know they're pregnant until week 4 or 5, and even if they stop taking their medication immediately, it takes another week to clear the system, he explained. By that time, organ formation is well underway and the critical period when antidepressants could have affected fetal development is over.
Another reason to keep women on antidepressants is Dr. Stowe's own finding that both SSRIs and tricyclic antidepressants have incomplete placental passage. A fetus receives a very low dose of these drugs, compared with other drugs - antibiotics or anticonvulsants, for example - that have complete placental passage.
In Dr. Stowe's recent study of 90 women who took fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft) during pregnancy, all three medications showed incomplete placental passage. All the babies born were healthy, with normal weight and a complication rate well below the national standards.
Hope this information helps. Wish you the best - complication-free pregnancy and a healthy baby.
Reference: Clinical Psychiatry News, March 2000.
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