Pristiq and pregnant

[chaynie32]

I'm 17 weeks pregnant and been on Pristiq since 2010 due to anxiety issues. My doctor advise me to stay on it to cause no risk to me and the baby. She gave me little information if my baby will be ok. Does anyone know of this will cause any problems? Can I still breastfeed? I heard it's never been tested on pregnant women. I'm so scared and need advice. Thanks

[Sandra]

Chaynie32,

Pristiq (desvenlafaxine) is rated P3-unknown-risk to to fetus cannot be ruled out. There are no adequate or well controlled studies in pregnant women.

At this time we have almost no data on desvenlafaxine. We do have a lot more on the parent of this drug, venlafaxine. Venlafaxine is metabolized in the body to desvenlafaxine.

The data on venlafaxine does not really suggest major developmental abnormalities. The data is not really clear. We do see a higher rate of discontinuation syndrome in infants exposed to venlafaxine, but true teratogenesis is not evident.

The other side of the equation, is that stopping this drug, and living with a worsened depression, if FAR worse than the side effects of this drug. Almost everyone in this field now recommends treatment of depression over the major complications induced by untreated depression.

My advice would be for her to stay on her desvenlafaxine during pregnancy.

Tom Hale Ph.D.

In breastfeeding Pristiq is rated an L3-limited data-probably compatible. The amount transferred into breast milk is 5.9-9.3% of your dose. The infant is usually exposed to more medication in utero than through breast milk, if you breastfeed it can decrease the risk of withdrawal symptoms in the infant. Monitor the infant for s[COLOR=#333333][FONT=lucida grande]edation or irritability, not waking to feed/poor feeding and weight gain.[/FONT][/COLOR]

I hope this helps.

Sandra Lovato R.N.
InfantRisk Center
806-352-2519