Safety of Newer Antidepressants in Pregnancy

Cynthia M. Way, B.Sc.Pharm.

Disclosures

Pharmacotherapy. 2007;27(4):546-552. 

In This Article

Venlafaxine

In the only published controlled study to date of venlafaxine use in pregnant women, the pregnancy outcomes of 150 women treated with venlafaxine in the first trimester were compared with those of 150 depressed women who received SSRIs and 150 women who took nonteratogenic drugs such as acetaminophen.[28] The investigators examined the frequency of major malformations; the rates of spontaneous or therapeutic abortions, live births, and stillbirths; gestational age at birth; and birth weight. In the venlafaxine group, there were 125 live births and 18 spontaneous abortions. Two major malformations occurred among the live-born babies exposed to venlafaxine. No significant differences were noted between the venlafaxine group and the other two groups in any of the outcomes studied. The authors concluded that venlafaxine does not increase the rate of major malformations above the baseline risk of 1-3%.

In a case series of 11 women who took venlafaxine during the first trimester, nine of the women delivered healthy babies, whereas two elected to terminate their pregnancies.[29]

As detailed in the SSRI section above, third-trimester exposure to venlafaxine may result in toxicity in the newborn.[30]

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