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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by maxime on August 1, 2006, at 20:08:42
Hi
I'm posting for a friend who just found out that she is pregnant. She takes Prozac, Wellbutrin and Concerta.
Can she takes these meds while pregnant? Will they harm the fetus or not?
Thanks.
Maxime
Posted by Phillipa on August 1, 2006, at 22:21:40
In reply to Meds and pregnancy (not me), posted by maxime on August 1, 2006, at 20:08:42
Maxie good to see you on the boards. Racer knows the meds for pregnacy. Maybe start a thread to her? Love Phillipa
Posted by maxime on August 1, 2006, at 23:40:46
In reply to Re: Meds and pregnancy (not me) » maxime, posted by Phillipa on August 1, 2006, at 22:21:40
> Maxie good to see you on the boards. Racer knows the meds for pregnacy. Maybe start a thread to her? Love Phillipa
Thanks Phillipa. :) Good idea ... I'll yell for Racer!
Maxime
Posted by maxime on August 1, 2006, at 23:43:15
In reply to Meds and pregnancy (not me), posted by maxime on August 1, 2006, at 20:08:42
> Hi
>
> I'm posting for a friend who just found out that she is pregnant. She takes Prozac, Wellbutrin and Concerta.
>
> Can she takes these meds while pregnant? Will they harm the fetus or not?
>
> Thanks.
>
> MaximeRacer what can you tell me? :)
maxime
Posted by octopusprime on August 2, 2006, at 10:25:45
In reply to Meds and pregnancy (not me), posted by maxime on August 1, 2006, at 20:08:42
Prescribing information sheet for Prozac: http://pi.lilly.com/prozac.pdf
Note the following: "Treatment of Pregnant Women During the Third Trimester
Neonates exposed to Prozac and other SSRIs or SNRIs, late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding (see PRECAUTIONS). When treating pregnant women with Prozac during the third trimester, the physician should carefully consider the potential risks and benefits of treatment. The physician may consider tapering Prozac in the third trimester."Prozac is category C, which means that further studies on fetal safety are necessary (ie the drug has not been proven safe or unsafe for fetuses).
Prescribing information sheet for Wellbutrin: http://us.gsk.com/products/assets/us_wellbutrinSR.pdf
Wellbutrin is also category C. The PI sheet has information about a pregnancy registry, which she should join. She can call and ask for additional information about wellbutrin during pregnancy.
Prescribing information sheet for Concerta: http://www.concerta.net/active/mccus/en_US/html/concerta/utilities/patient_info.pdf#zoom=100
Concerta is also category C.
She should call her pdoc immediately and tell him/her that she is pregnant and ask for advice on the continuation of this medication. Many women take category C medication during pregnancy without harm to the fetus. That said, there is no definitive proof that the medication is safe for the fetus.
Your friend may be stable enough to consider weaning off the medication to avoid any possible risk to the baby. If the benefits of medication outweigh the risk, then she can continue taking the meds. If I were her, I would consider going off the Prozac, staying on Wellbutrin, and then staying on Concerta. I might also consider finding a non-SSRI substitute for Prozac. Personally, I took Lamictal (another category C drug) through both my pregnancies. I miscarried the first at 11 weeks, and I am now at 20 weeks with the second. With this pregnancy the triple screen and the ultrasounds are showing no increased risk of birth defects/no signs of birth defects.
Congratulations to your friend and good luck making a decision.
Posted by Maxime on August 2, 2006, at 14:08:21
In reply to Re: Meds and pregnancy (not me) » maxime, posted by octopusprime on August 2, 2006, at 10:25:45
Thanks for all the info ... I will pass it on to her. I told her to call a pharmacist and see her doctor ASAP.
Thanks again. :)
maxime
Posted by Racer on August 4, 2006, at 1:36:11
In reply to Re: Meds and pregnancy (not me) » octopusprime, posted by Maxime on August 2, 2006, at 14:08:21
Prozac and Concerta are contraindicated, but Wellbutrin is a different story...
Wellbutrin was Category B until a few weeks (months?) ago, and it was not moved because of any new studies. It was moved because with the new worries about SSRIs, someone looked at the same studies that said Wellbutrin was safe, and decided they weren't good enough. But until about the middle of this year, Wellbutrin was Category B.
How confident do I feel about all this? I'm still taking Wellbutrin, and wouldn't consider taking an SSRI based on what I've read.
My soon-to-be-ex pdoc, by the way, says that I'm being too cautious, and that SSRIs only result in a few days of withdrawal for the new babies. I do'nt believe that, but I do know that she's up to date on conferences, studies, etc.
Hope that helps.
Posted by Phillipa on August 4, 2006, at 11:22:02
In reply to Re: Meds and pregnancy (not me) » Maxime, posted by Racer on August 4, 2006, at 1:36:11
Babies are going into withdrawal from SSRI's? I know so many people my niece included who gave birth on an SSRI. What kind of withdrawal do they have to go through? I thought the categories were for bith defects. Love Phillipa
Posted by SLS on August 5, 2006, at 8:03:55
In reply to Re: Meds and pregnancy (not me) » Racer, posted by Phillipa on August 4, 2006, at 11:22:02
"The clinical presentation of fluoxetine withdrawal depends on the timing and amount of last maternal use, maternal and infant metabolism and excretion. The most commonly reported neonatal symptoms include agitation, irritability, impending seizures, hypertonia or hypotonia, hyperreflexia, drowsiness, jitteriness, feeding problems, persistent crying, tachypnoea, temperature instability, acrocyanosis and tremors. In addition fluoxetine toxicity has been observed as scattered petechiae over the face and trunk along with cephalhaematoma(5), marked motor automatism and skin manifestations(6). It has also been associated with colic(3), lipomeningocele(4), and cardiac arrhythmia(7). Due to its longer half life (2-3 days) the withdrawal symptoms due to fluoxetine are usually mild and self limiting compared to other SSRI’s. Moreover it is obvious from the published work that majority of the reported cases of suspected SSRI-induced neonatal withdrawal syndrome are due to Paroxetine and fluoxetine(9)."
http://www.indianpediatrics.net/jan2006/jan-66-69.htm
This is the end of the thread.
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