Posted by Mitchell on August 2, 2001, at 22:43:39
In reply to Re: pathology, posted by stjames on August 2, 2001, at 10:20:35
> > > nor is there a test to prove why anyone lost a baby.
> > Pathologists employ an extensive array of tests to determine causes of fetal deaths.
> But there is not one for Effexor
There is a serum test for venlaxafine. High performance liquid chromatography can be used to determine serum levels of venlafaxine (Effexor). The test is available through numerous pathology laboratories.
There might not have been any prenatal deaths medically attributed to venlaxafine.
Of 14 reported adult overdoses of venlafazine, none has been reported as fatal, according to Dr. Ivan Goldberg's venlafaxine FAQ, posted elsewhere on this site and elsewhere on the Net.
Dr. Goldberg also reports that "There is no data to establish the safety of venlafaxine for the fetus or nursing infant."
In "Psychotropic medications in pregnant women: treatment dilemmas " (1998) Marie-Paule V. Austin and Philip B. Mitchell conclude that: "The lack of data on the newer antidepressants (moclobemide, venlafaxine, nefazodone) probably reflects their more recent entries onto the market."
In "A Review of pregnancy outcome following exposure to newer antidepressants" (August 1995), Helen E. Swaby, Pharm.D. reported that:
"In rat animal studies of venlaxafine at 10 times (mg/kg basis) the maximum human daily dose, there was a decrease in pup weight, an increase in stillborn pups, and an increase in pup deaths during the first 5 days of lactation. It again is cautioned that animal reproductive studies are not predictive of human response."Although a negative pregnancy test was required prior to enrollment in clinical trials, fourteen pregnancies were reported among 1239 venlafaxine-treated women. According to data on file from Wyeth-Ayerst laboratories, there were five full-term births in the venlafaxine group with normal outcomes. Fetal exposure to venlafaxine in the five pregnancies occurred in the first trimester. One ectopic pregnancy was reported in a woman with a history of two spontaneous abortions. Three spontaneous abortions were reported in total, one patient was lost to follow-up and the remaining women terminated their pregnancies via elective abortions. Wyeth-Ayerst also states they have received rare spontaneous reports of congenital anomalies (including craniofacial abnormalities) which coincide with the use of venlafaxine during the first trimester of pregnancy."
http://www.pharmacy.umaryland.edu/~umdi/ssripreg.htmI do not intend to comment on the safety of venlaxafine use by pregnant women, but only to demonstrate that the question is of scientific interest.
Skepticism about a claim that venlaxafine caused a fetal death is probably appropriate, for the purpose of scientific reasoning.
On the other hand, a woman's perception that the drug played a role in the death of her fetus can be an important consideration, for that woman and for her choice of a treatment regimen. If, at the time of a miscarriage, a woman reported suspicions related to venlaxafine use, the occasion might also suggest an opportunity to preserve fetal remains for testing.
Whether it is helpful in this instance to speculate about a woman's claims that she lost a fetus, and that venlaxafine caused the miscarriage, is another matter about which I do not care to speculate.
poster:Mitchell
thread:1689
URL: http://www.dr-bob.org/babble/admin/20010718/msgs/1706.html