How Safe Is Venlafaxine in Pregnancy?

Venlafaxine, also known as Efflexor XR® is an anti-depressant in the selective serotonin and norepinephrine reuptake inhibitor (SSNRI) category. Its main function is to treat mild to severe depression, but it may also be used for panic attacks and severe cases of anxiety. There are only a few controlled tests on using Venlafaxine in pregnancy, but as of 2011, no major birth defects have been associated with its use. Research does suggest that the baby may incur other health problems though, especially withdrawal symptoms if a mother uses Venlafaxine in pregnancy during the last three months. Doctors generally recommend discussing the benefits and risks of using the medication during pregnancy as the variables may vary dramatically with each patient.

As of 2011, the US Food and Drug Administration (FDA) categorized Venlafaxine as category C. This means there is either not enough well-controlled clinical trials on human subjects or there were fetal development issues in animal pregnancies. The studies performed showed no concrete evidence that birth defects were associated with using Venlafaxine in pregnancy. Results do show, however, that withdrawal and other health problems in the infant may be associated with Venlafaxine use.

Some babies have shown withdrawal symptoms immediately after birth, which have lasted for several days. Other health problems have also been displayed in infants if their mother used Venlafaxine in pregnancy during the last three months before the birth. The main symptoms that have been a cause for concern include respiratory problems, apnea, jitters, irritability, constant crying, vomiting, jaundice, difficulty feeding, seizure, hypertonia and hypotonia. As such, it is generally recommended that a neonatal support system is present at birth so the infant may receive immediate care. Some research suggests that using anti-depressants may lower the child’s IQ, though as of 2011, this has not yet been proven true of Venlafaxine.

While these factors may prove to be worrisome for some women, discussing the benefits and risks of Venlafaxine use during pregnancy with a doctor is recommended before any action is taken. This is because there are still several benefits of using Venlafaxine in pregnancy. Stopping the medication may lead to a relapse in depression, which means there is a higher risk of reduced prenatal health. Preterm labor and slower development in the child after birth are other risks. It is also believed that stopping medication may also increase the risk of postpartum depression.

If a mother decides to stop taking Venlafaxine in pregnancy, it must be done slowly. Abruptly stopping may lead to withdrawal symptoms that may become worse in pregnancy. Symptoms include tremors, palpitations, vomiting, light numbness, mood swings and diarrhea. A doctor may recommend a tapering schedule to fit the mother’s individual needs.