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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Rosa on September 8, 2001, at 13:15:09
What drugs affect the ability to have children?Many medications have a caution not to take during pregnancy.
What about antidepressants?
What about Depakote?
Posted by SalArmy4me on September 8, 2001, at 13:18:22
In reply to Medications and Sterility, posted by Rosa on September 8, 2001, at 13:15:09
Pregnancy Outcome Following Maternal Use of the New Selective Serotonin Reuptake Inhibitors: A Prospective Controlled Multicenter Study
Kulin NA, Pastuszak A, Sage SR, et al (Univ of Toronto; Teratogen Information Service, Tampa, Fla; Pennsylvania Hosp, Philadelphia; et al); JAMA 279:609-610, 1998:"Background.-Selective serotonin reuptake inhibitors (SSDIs) were introduced about 10 years ago and are now used for depression by millions of individuals around the world. Fetal safety is a major concern, because more than 50% of all pregnancies are unplanned, and an estimated 8% to 20% of all women have depression. Studies of pregnancy outcome after maternal exposure to fluoxetine have reported no evidence of major malformations or behavioral teratology, although women exposed to fluoxetine throughout their pregnancy did have more perinatal complications and minor malformations. New SSRIs have been introduced recently and there are no data on their reproductive safety in human beings.
Methods.-Nine Teratology Information Service centers in the United States and Canada participated in a study of fetal safety and risk of fluvoxamine, paroxetine, and sertraline. The rate of major congenital malformations was determined in women who were counseled during pregnancy and evaluated after exposure to fluvoxamine, paroxetine, or sertraline. The rate of major congenital malformations was also determined in a group of control participants who were counseled after exposure to nonteratogenic agents.
Results.-There were 267 women who took fluvoxamine, paroxetine, or sertraline for depression in the first trimester of pregnancy; 267 control participants. Exposure to the SSRIs was not associated with a higher risk of major malformations or with a higher rate of miscarriage, stillbirth, or prematurity. The mean birth weight and gestational age were similar in the study and control groups.
Discussion.-These findings indicate that fluvoxamine, paroxetine, and sertraline, when used at recommended doses, do not increase the risk of major congenital malformations in pregnant women. On all measured pregnancy outcomes, these results were well within the range of results reported for the general population.
[r tri, filled] This article should be welcomed by clinicians who wrestle with the use of antidepressants in pregnant patients. These clinicians often have to balance the risk of fetal harm against the risk of not treating depressive illness, and to consider what effects no treatment might have on fetal development, because problems with nutrition and other aspects of poor self-care are associated with depression. These investigators found no adverse effect from newer SSRIs. We may not be able to breathe easy based solely on studies like this, but these data certainly add to the rationale for use of these agents in depressed pregnant mothers, and also provide good medical/legal defense for those of us who bite the bullet and do the right thing. The apparent lack of industry support for this particular study is also comforting. The authors report that anatomically correct children were born to mothers taking these agents. It would be useful to push this envelope a little further by assessing postnatal development (cognitive and perceptual/motor skills) for at least 3 to 5 years, in children who were exposed in utero. I applaud the authors for their careful work, which is likely to benefit both clinicians and patients by assuring us that treatment of depression in pregnant women does not appear to be dangerous to the fetus."
R.B. Lydiard, Ph.D., M.D.
Professor of Psychiatry and Behavioral Sciences, Medical University of South Carolina; Director, Clinical Psychopharmacology Research Division, Institute of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Posted by SalArmy4me on September 8, 2001, at 13:23:21
In reply to Medications and Sterility, posted by Rosa on September 8, 2001, at 13:15:09
Brodie, Martin J. Drug Therapy: Antiepileptic Drugs. New England Journal of Medicine. 334(3):168-175, January 18, 1996:
"Valproic acid (Depakote) and carbamazepine are associated with a higher incidence of neural-tube defects than that in the general population -- approximately 1 to 2 percent and 0.5 to 1 percent, respectively [68,69]. In an attempt to prevent such defects, folic acid should be given both before and after conception. The current recommendations are 5 mg of folic acid per day for women who have had a child with a neural-tube defect and 0.4 mg daily for all other women planning a pregnancy [70]. It seems sensible to recommend the 5-mg dose for women being treated with valproic acid or carbamazepine."
Posted by Rosa on September 8, 2001, at 15:42:58
In reply to Re: Depakote in Pregnancy » Rosa, posted by SalArmy4me on September 8, 2001, at 13:23:21
I was referring to "male" sterility; this was written for a friend. He wants to know if his taking drugs will prevent him from having children.
Rosa
> Brodie, Martin J. Drug Therapy: Antiepileptic Drugs. New England Journal of Medicine. 334(3):168-175, January 18, 1996:
>
> "Valproic acid (Depakote) and carbamazepine are associated with a higher incidence of neural-tube defects than that in the general population -- approximately 1 to 2 percent and 0.5 to 1 percent, respectively [68,69]. In an attempt to prevent such defects, folic acid should be given both before and after conception. The current recommendations are 5 mg of folic acid per day for women who have had a child with a neural-tube defect and 0.4 mg daily for all other women planning a pregnancy [70]. It seems sensible to recommend the 5-mg dose for women being treated with valproic acid or carbamazepine."
Posted by SalArmy4me on September 8, 2001, at 15:47:37
In reply to Re: Depakote in Pregnancy, posted by Rosa on September 8, 2001, at 15:42:58
I couldn't find that to be true, even after scouring all the major medical journals' full-texts.
Posted by Rosa on September 8, 2001, at 15:56:29
In reply to Re: Medications and Sterility » Rosa, posted by SalArmy4me on September 8, 2001, at 13:18:22
Selective serotonin reuptake inhibitors (SSDIs) were introduced about 10 years ago and are now used for depression by millions of individuals around the world. Fetal safety is a major concern, because more than 50% of all pregnancies are unplanned, and an estimated 8% to 20% of all women have depression.
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Setraline (Zoloft)Specifically referring to Risperdol, Depakote and Celexa in this case although other medications are unknown. This pertains to sterility in a male.
-------------------------
> Pregnancy Outcome Following Maternal Use of the New Selective Serotonin Reuptake Inhibitors: A Prospective Controlled Multicenter Study
> Kulin NA, Pastuszak A, Sage SR, et al (Univ of Toronto; Teratogen Information Service, Tampa, Fla; Pennsylvania Hosp, Philadelphia; et al); JAMA 279:609-610, 1998:
>
> "Background.-Selective serotonin reuptake inhibitors (SSDIs) were introduced about 10 years ago and are now used for depression by millions of individuals around the world. Fetal safety is a major concern, because more than 50% of all pregnancies are unplanned, and an estimated 8% to 20% of all women have depression. Studies of pregnancy outcome after maternal exposure to fluoxetine have reported no evidence of major malformations or behavioral teratology, although women exposed to fluoxetine throughout their pregnancy did have more perinatal complications and minor malformations. New SSRIs have been introduced recently and there are no data on their reproductive safety in human beings.
>
> Methods.-Nine Teratology Information Service centers in the United States and Canada participated in a study of fetal safety and risk of fluvoxamine, paroxetine, and sertraline. The rate of major congenital malformations was determined in women who were counseled during pregnancy and evaluated after exposure to fluvoxamine, paroxetine, or sertraline. The rate of major congenital malformations was also determined in a group of control participants who were counseled after exposure to nonteratogenic agents.
>
> Results.-There were 267 women who took fluvoxamine, paroxetine, or sertraline for depression in the first trimester of pregnancy; 267 control participants. Exposure to the SSRIs was not associated with a higher risk of major malformations or with a higher rate of miscarriage, stillbirth, or prematurity. The mean birth weight and gestational age were similar in the study and control groups.
>
> Discussion.-These findings indicate that fluvoxamine, paroxetine, and sertraline, when used at recommended doses, do not increase the risk of major congenital malformations in pregnant women. On all measured pregnancy outcomes, these results were well within the range of results reported for the general population.
>
> [r tri, filled] This article should be welcomed by clinicians who wrestle with the use of antidepressants in pregnant patients. These clinicians often have to balance the risk of fetal harm against the risk of not treating depressive illness, and to consider what effects no treatment might have on fetal development, because problems with nutrition and other aspects of poor self-care are associated with depression. These investigators found no adverse effect from newer SSRIs. We may not be able to breathe easy based solely on studies like this, but these data certainly add to the rationale for use of these agents in depressed pregnant mothers, and also provide good medical/legal defense for those of us who bite the bullet and do the right thing. The apparent lack of industry support for this particular study is also comforting. The authors report that anatomically correct children were born to mothers taking these agents. It would be useful to push this envelope a little further by assessing postnatal development (cognitive and perceptual/motor skills) for at least 3 to 5 years, in children who were exposed in utero. I applaud the authors for their careful work, which is likely to benefit both clinicians and patients by assuring us that treatment of depression in pregnant women does not appear to be dangerous to the fetus."
>
> R.B. Lydiard, Ph.D., M.D.
>
> Professor of Psychiatry and Behavioral Sciences, Medical University of South Carolina; Director, Clinical Psychopharmacology Research Division, Institute of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Posted by Rosa on September 9, 2001, at 6:07:43
In reply to Re: Depakote in Pregnancy » Rosa, posted by SalArmy4me on September 8, 2001, at 15:47:37
Let me change the Subject to reflect the information that I am seeking. Thanks. While this may apply to pregnancy, the information I am seeking applies to sterility in men.
> I couldn't find that to be true, even after scouring all the major medical journals' full-texts.
Posted by Rosa on September 9, 2001, at 6:36:46
In reply to Medications and Sterility, posted by Rosa on September 8, 2001, at 13:15:09
Does Risperdal have any affect on the ability to have children?
>
> What drugs affect the ability to have children?
>
> Many medications have a caution not to take during pregnancy.
>
This is the end of the thread.
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