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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Preggo Leah on March 5, 2001, at 23:12:32
I've been on effexor for a little over 2 years now, and honestly, it's probably saved my life. I've tried other drugs, but they either seemed to have no effect or just left me feeling "glazed over."
Anyway, I just found out that I'm pregnant---btw 4-6 weeks---and I'm very concerned because I've been on a pretty high dosage (300 mg/day). I'm definitely going to get off effexor for the time being--until I've delievered and finished breastfeeding--but am concerned that perhaps I've already done some type of damage to the baby through my meds. I haven't been able to find any information on effexor and pregnancy (except "don't take this if you are pregnant..."), and am really pretty nervous. Please help!!
Posted by Leonardo on March 6, 2001, at 4:49:52
In reply to Please help!! major concern, posted by Preggo Leah on March 5, 2001, at 23:12:32
Hi Leah
Congratulations! I guess this should be a time of celebration, so I'm sorry to hear you've got this added worry.
I don't know if Effexor has any specific dangers in pregnancy, but I haven't heard of any bad reports. I think there is a general 'don't use antidepressants in pregnancy' warning just because it is an avoidable possible risk. Ideally you wouldn't smoke or drink before pregnancy and take lots of exercise and folic acid etc, but most people who don't ake these precautions still have healthy babies.
What I would say is, if you are coming off Effexor, don't do it very suddenly even though you are concerned for the baby. That too can have bad side effects which won't help you or your baby.
I'm pretty sure I read in a book about depresion and meds, that coming off ADs in pregnancy can have a worse effect overall if your depression returns.
Obviously, consult with your doctor, but I reckon you should allow yourself a few weeks to gradually get off the Effexor, and be prepared for possibly going back on it if you get badly depressed.
Maybe someone else here will know if there are specific known dangers, or be able to advise how to get off Effexor as quickly as possible - cold turkey often gives people serious problems from reports on here.
Best wishes
Leonardo> I've been on effexor for a little over 2 years now, and honestly, it's probably saved my life. I've tried other drugs, but they either seemed to have no effect or just left me feeling "glazed over."
> Anyway, I just found out that I'm pregnant---btw 4-6 weeks---and I'm very concerned because I've been on a pretty high dosage (300 mg/day). I'm definitely going to get off effexor for the time being--until I've delievered and finished breastfeeding--but am concerned that perhaps I've already done some type of damage to the baby through my meds. I haven't been able to find any information on effexor and pregnancy (except "don't take this if you are pregnant..."), and am really pretty nervous. Please help!!
Posted by Ted on March 6, 2001, at 10:59:18
In reply to Re: Please help!! major concern » Preggo Leah, posted by Leonardo on March 6, 2001, at 4:49:52
Hi Leah,
I have only one thing to add to Leonardo's response: If you suffer chronic major depression, you have a tremendous risk for post-partum depression as well. Make sure you have someone lined up to care for **you** for several months after delivery if needed (family?). This happened to a friend; his wife needed 9 months following delivery to recover. Mom, dad, and baby are all fine -- it just took time, patience, and the extra care of their families. Don't be afraid -- just be prepared.
Good luck and CONGRATULATIONS!
Ted
Posted by Noa on March 6, 2001, at 14:36:12
In reply to Re: Please help!! major concern, posted by Ted on March 6, 2001, at 10:59:18
In the book When Words Are Not Enough, I read that it takes a few weeks for the vascular network that connects mother to fetus to develop, so you have a bit of time to get off meds if that is what you decide. You should definitely consult your pdoc and your ob.
Also, there are two books out that talk a lot about issues particulary pertaining to women, and I know talk a lot about pregnancy (whether about this particular issue, I don't know) and you should take a look there:
Screaming to Be Heard by Elizabeth Vliet
and
Women's Moods by Deborah Sichel.Both are reviewed at Dr. Bob's "Books" page, under the PsychoBabble recommendations.
Good luck.
Posted by Leonardo on March 6, 2001, at 18:32:10
In reply to Please help!! major concern, posted by Preggo Leah on March 5, 2001, at 23:12:32
Hi Leah
If you're still thinking about this, I found some more info.
Dr Bob posted some relevant links to other parts of this site a while back:
http://www.dr-bob.org/tips/split/Antidep-preg-lactation.html
http://www.dr-bob.org/tips/split/Medications-during-pregnan.html
http://www.dr-bob.org/tips/split/Antidepressants-during-pre.html
http://www.dr-bob.org/tips/split/Medications-during-breast-.html
http://www.dr-bob.org/tips/split/Antidepressants-during-bre.htmlOne of these gives the info:
From: BJSCHWARTZ@delphi.com
Date: Mon, 07 Apr 1997 19:55:27 -0400 (EDT)
Subject: Medication during pregnancyThere ia a "teratology hotline" in Utah that evaluates all meds in terms of conception and on through nursing. The number is (801) 328-2229. Call them once and they will give you a local number.
At http://www.priory.co.uk/focus1.htm Dr Ivan Goldberg has an article 'Focus on venalafaxine'. In response to the question: "Is venlafaxine safe for a woman who is pregnant, about to become pregnant, or nursing an infant?" he replies:
"There is no data to establish the safety of venlafaxine for the fetus or nursing infant."
This is probably better news than it sounds. There have been studies of pregnant women taking SSRI antidepressants which *may* show *some* increased risks for the baby, but they are not very conclusive. There don't appear to be any studies for venlafaxine (Effexor), which probably means that there have been few reports of suspected problems to prompt any monitoring. Some of the reports in the Dr Bob tips above mention moving women to Effexor from other drugs as it seems to have lower risk, especially for breastfeeding. So on balance it seems unlikely that the Effexor will have done your baby any harm.
There are actually websites dedicated to the problems of getting off Effexor, prompted by some people's bad experiences. So if you decide to stop taking it, I'd suggest you do some research to be prepared, and allow at least 1-2 weeks to wean off it. See http://www.socialaudit.org.uk/9425vfx.htm#RE and linked sites http://members.tripod.com/bwarner/effexor.html and http://www.effexorfx.freeuk.com/
Some people get raised blood pressure as a side effect from Effexor, which could give problems in later pregnancy I guess. This effect is supposed to be much reduced if you take 200mg or less per day. You could compromise by trying to get by on a lower dose. Or maybe your pregnancy hormones would give you a boost without the Effexor.
Let us know how you get on!
Leonardo
> I've been on effexor for a little over 2 years now, and honestly, it's probably saved my life. I've tried other drugs, but they either seemed to have no effect or just left me feeling "glazed over."
> Anyway, I just found out that I'm pregnant---btw 4-6 weeks---and I'm very concerned because I've been on a pretty high dosage (300 mg/day). I'm definitely going to get off effexor for the time being--until I've delievered and finished breastfeeding--but am concerned that perhaps I've already done some type of damage to the baby through my meds. I haven't been able to find any information on effexor and pregnancy (except "don't take this if you are pregnant..."), and am really pretty nervous. Please help!!
Posted by Sunnely on March 6, 2001, at 21:48:38
In reply to Please help!! major concern, posted by Preggo Leah on March 5, 2001, at 23:12:32
Hi Preggo Leah,
I believe the following is the latest opinion regarding antidepressants and pregnancy.
ANTIDEPRESSANTS APPEAR SAFE DURING PREGNANCY
Women who use antidepressants during pregnancy are not significantly increasing the risk of congenital malformations in their infants, according to results of a large prospective study.
Dr. A Ericson of the Centre for Epidemiology in Stockhom and colleagues followed 969 women who reported antidepressant use at a prenatal visit around weeks 10-12. There were 980 births, including 11 sets of twins. The incidence of birth defects was 4% and the incidence of infant mortality was 0.7% - no different from the rates in the general population.
The data came from the Swedish Medical Birth Registry, which includes information from prenatal visits, delivery, and the first pediatric examination.
Five hundred thirty-one women used SSRIs alone during pregnancy, 15 used SSRIs in combination with another antidepressant, and 423 used a non-SSRI antidepressant alone. The SSRIs used were citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). The non-SSRIs used were amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), lofepramine, nortriptyline (Pamelor), maprotiline (Ludiomil), mianserin, moclobemide (Manerix), trimipramine (Surmontil), and venlafaxine (Effexor).
Citalopram, for which no previous data on congenital malformation effects exist, was the most popular antidepressant and was used by 39% of the women. Congenital anomalies did not appear more frequently in the infants of these women than in infants exposed to other SSRIs.
Over 40% of the women reported using other medications during pregnancy, including other psychotropics, analgesics, anti-asthmatic drugs, antibiotics, anti-inflammatory drugs, sex hormones, thyroid hormones, anti-epileptics, and insulin. There was no correlation between use of other medications and use of any class of antidepressant.
Dr. Zachary Stowe, Director of the Pregnancy and Postpartum Mood Disorder Program at Emory University, commenting on the above study, agreed with the suggestion of Dr. Ericson and colleagues that untreated depression can expose the mother and the child to risks associated with substance abuse, poor nutrition, and suicidal tendencies. He stated, "If they have a history of being able to come off (their antidepressants) and be OK, then do it. But if you take them off the medication and they get sick and need to go back on it, you're exposing the fetus both to antidepressant and to untreated depression." In his view, this is the worst of both worlds.
In a recent multicenter prospective study by Dr. Stowe, 112 women were taking antidepressants when they became pregnant, and all discontinued medication as soon as they discovered their pregnancy. Around 70% of them developed depressive symptoms in the course of pregnancy, and by the time their babies were born, 50% had started taking antidepressant again.
Even if a woman is able to stay off her antidepressant for the duration of pregnancy, it may not help that much. Most women don't know they're pregnant until week 4 or 5, and even then if they stop taking medication immediately, it takes another week to clear the system, he explained. By that time, organ formation is well underway and the critical period when antidepressants could have affected fetal development is over. (Stopping the antidepressants can also lead to withdrawal symptoms. Effexor is notorious for rapid-onset and very nasty withdrawal symptoms.)
Another reason to keep women on antidepressants is Dr. Stowe's own finding that both SSRIs and tricyclic antidepressants have incomplete placental passage. A fetus receives a very low dose of these drugs, compared with other drugs - antibiotics or anticonvulsants, for example - that have complete placental passage.
In Dr. Stowe's recent study of 90 women who took fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft) during pregnancy, all three medications showed incomplete placental passage. All the babies born were healthy, with normal weight and a complication rate well below the national standards.
Hope this helps. Wish you the best - pregnancy and baby.
+++++++++++++++++++++++++++++++++++++++++++++++
> I've been on effexor for a little over 2 years now, and honestly, it's probably saved my life. I've tried other drugs, but they either seemed to have no effect or just left me feeling "glazed over."
> Anyway, I just found out that I'm pregnant---btw 4-6 weeks---and I'm very concerned because I've been on a pretty high dosage (300 mg/day). I'm definitely going to get off effexor for the time being--until I've delievered and finished breastfeeding--but am concerned that perhaps I've already done some type of damage to the baby through my meds. I haven't been able to find any information on effexor and pregnancy (except "don't take this if you are pregnant..."), and am really pretty nervous. Please help!!
Posted by Marilyn on March 7, 2001, at 7:25:09
In reply to Please help!! major concern, posted by Preggo Leah on March 5, 2001, at 23:12:32
Hi Preggo Leah,
Please visit these URL:
http://www.health.gov.au/tga/docs/html/aadrbltn/aadr9711.htm#ssri
If I were you I would pay a visit to my doctor to ask him to help me weaning off this drug.
Take care,Marilyn
> I've been on effexor for a little over 2 years now, and honestly, it's probably saved my life. I've tried other drugs, but they either seemed to have no effect or just left me feeling "glazed over."
> Anyway, I just found out that I'm pregnant---btw 4-6 weeks---and I'm very concerned because I've been on a pretty high dosage (300 mg/day). I'm definitely going to get off effexor for the time being--until I've delievered and finished breastfeeding--but am concerned that perhaps I've already done some type of damage to the baby through my meds. I haven't been able to find any information on effexor and pregnancy (except "don't take this if you are pregnant..."), and am really pretty nervous. Please help!!
This is the end of the thread.
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