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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 Cindylou on August 27, 2001, at 7:53:44
Hello,
I have heard that Effexor and Prozac are safe during pregnancy. Does anyone know of other antidepressants that are safe (don't cross the placenta) during pregnancy? Are MAOIs strictly "out?" I had a miscarriage on a Zoloft + Wellbutrin combo, so those are out for me.
My last pregnancy I went off ADs altogether, and suffered extreme post-partum depression after delivery. My ob/gyn wants me to consider staying on meds this time -- or at least to start taking them during the third trimester.
Looking for information and experiences.
Thanks,
cindy
Posted by girlie on August 27, 2001, at 10:47:52
In reply to Which ADs are best during pregnancy?, posted by Cindylou on August 27, 2001, at 7:53:44
> Hello,
>
> I have heard that Effexor and Prozac are safe during pregnancy. Does anyone know of other antidepressants that are safe (don't cross the placenta) during pregnancy? Are MAOIs strictly "out?" I had a miscarriage on a Zoloft + Wellbutrin combo, so those are out for me.
>
> My last pregnancy I went off ADs altogether, and suffered extreme post-partum depression after delivery. My ob/gyn wants me to consider staying on meds this time -- or at least to start taking them during the third trimester.
>
> Looking for information and experiences.
>
> Thanks,
> cindy
I have not seen ANY conclusive information that says that Effexor is SAFE during pregnancy. Where did you get this info?girlie
Posted by Cindylou on August 27, 2001, at 13:02:51
In reply to Re: Which ADs are best during pregnancy? » Cindylou, posted by girlie on August 27, 2001, at 10:47:52
Actually, I got the information from this board --there's an earlier post in this session about Effexor and pregnancy -- SalArmy posted research findings that pregnancy and breastfeeding were safe with Effexor.
As for me, I couldn't tolerate Effexor's side effects, so I wouldn't be taking that one during pregnancy anyway -- I am currently on Prozac which isn't helping much; that's why I'm looking for other options. My husband and I are planning to "start trying" next Spring, so I have time to plan what to do with my medication issues.
> I have not seen ANY conclusive information that says that Effexor is SAFE during pregnancy. Where did you get this info?
>
> girlie
Posted by Jane D on August 27, 2001, at 13:41:39
In reply to Re: Which ADs are best during pregnancy? » girlie, posted by Cindylou on August 27, 2001, at 13:02:51
> Actually, I got the information from this board --there's an earlier post in this session about Effexor and pregnancy -- SalArmy posted research findings that pregnancy and breastfeeding were safe with Effexor.
>Cindylou,
I "think" this information may be correct but it is not a good idea to rely on any information you get from this board alone. You also don't want to rely on an abstract of a single study. It could have been financed by the manufacturer, included only three people, or there could be five more studies that say the opposite. You just have no way of knowing.Either do a search of the abstracts yourself at pub med or talk to a doctor you trust. Or better yet, do both.
Jane
Posted by SLS on August 27, 2001, at 16:00:29
In reply to Which ADs are best during pregnancy?, posted by Cindylou on August 27, 2001, at 7:53:44
> Hello,
>
> I have heard that Effexor and Prozac are safe during pregnancy. Does anyone know of other antidepressants that are safe (don't cross the placenta) during pregnancy? Are MAOIs strictly "out?" I had a miscarriage on a Zoloft + Wellbutrin combo, so those are out for me.
>
> My last pregnancy I went off ADs altogether, and suffered extreme post-partum depression after delivery. My ob/gyn wants me to consider staying on meds this time -- or at least to start taking them during the third trimester.
>
> Looking for information and experiences.
>
> Thanks,
> cindy
Hi Cindy.Being out the longest of the SSRIs, Prozac has so far not evidenced any teratogenic effects (birth defects). However, I think one must take into consideration that the infant might experience a SSRI withdrawal syndrome post natal. Among the SSRIs, Prozac is probably the least likely to cause this given it is metabolized more slowly (leading to a more gradual decrease in blood levels). The infant would probably display some signs of agitation, insomnia, or nausea. I don't think there is a lot of stuff to be found in the literature about this, but recognizing the potential for this reaction would help to explain these symptoms should they occur. I doubt any harm is done, just some transient discomfort.
If I recall, I believe a few studies indicated that the frequency of premature births was slightly higher with Prozac, and the average body weight somewhat lower. There has been mention of increased incidence of miscarriage, but I don't think the numbers are convincing.
Another thing to consider is that both Prozac and Celexa are secreted into breast milk to an appreciable extent. However, one study determined that the levels found in the infant's blood stream were about 1/10 of what is considered to be therapeutic in adults. Some doctors recommend monitoring the infant. Other than colic, I don't know what one would monitor for. Overall, I don't see too much concern in the medical literature contained on Medline over this issue.
One caveat offered by some investigators regarding breast feeding with Prozac is that it might not be such a good idea if there is concern that the infant is of below average body weight, as weight loss is a common side effect with this drug. With the possible exception of doxepin (Sinequan), tricyclics do not accumulate in breast milk to an appreciable extent.
The drugs that have been available the longest, the tricyclics, have proven themselves to be safe for use during pregnancy. They have been around for over 40 years. Given your unsatisfactory response to Prozac, it can be argued that the tricyclic antidepressants desipramine or nortriptyline would be a rational choice.
- Scott
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