Posted by ed_uk on July 1, 2005, at 12:40:59
Clinical question
Is bupropion (Zyban, Wellbutrin) use during pregnancy associated with an increased risk of major malformations?
Bottom line
Bupropion is not associated with increased rates of major malformations. It may be associated with an increase in spontaneous abortions.
Synopsis
Bupropion is prescribed for both depression and smoking cessation (although it is not licensed for use in depression in the UK). In this prospective study 136 women using bupropion and who were either planning pregnancy or already pregnant were enrolled. All women were exposed to bupropion during the first trimester of pregnancy and 45 continued use throughout the pregnancy. Participants were matched on the basis of age, alcohol use, smoking and gestational age at enrolment with two comparison groups: women taking other antidepressants and women without any known exposure to possible teratogens. There were no major malformations in the bupropion-treated group, one in the group of women exposed to other antidepressants, and two in the non-teratogen group. Spontaneous abortions were 15 per cent in the bupropion group, 12 per cent in the other antidepressant group and 7 per cent in the non-teratogen group. Other secondary outcomes including stillbirths, gestational age at delivery and birth weight, did not differ between groups. Although not a large study, these data are reassuring.
Level of evidence 1b (individual randomised controlled trial with narrow confidence interval).
Reference Chun-Fai-Chan B, Koren G, Fayez I, et al. Pregnancy outcome of women exposed to bupropion during pregnancy: A prospective comparative study. Am J Obstet Gynecol 2005;192:932-36.
poster:ed_uk
thread:521975
URL: http://www.dr-bob.org/babble/20050627/msgs/521975.html