Remeron for anxiety/depression while pregnant

[BPep]

I'm currently 27 weeks pregnant and have been taking 7.5mg of Remeron(mirtazapine) during this pregnancy for my anxiety and depression. I have tried all other medications, including the ssri's that are recommended for pregnant woman. This dose of Remeron works, and helps me from not having panic attacks. My baby has been growing great, and is healthy.

My question is, is it safe to continue taking this dose throughout the remainder of my pregnancy and labor, or should I taper down before giving birth? I know this dose works, and I know I am predisposed to post partum depression, and I will need to continue the medication after birth.

Any insight would be helpful. Thank you!

[ca2012]

I am also interested in the research on this drug during pregnancy. Any information would be appreciated.

[admin-james]

Hi, thanks for your post.

Remeron (mirtazapine) is an FDA pregnancy category C. Animal studies have shown an increased risk of spontaneous abortion in the first trimester at doses far in excess of typical human doses. There was no increase in birth defects. There is only one controlled study available on mirtazapine safety in pregnant women. These authors confirmed no increase in birth defects attributable to mirtazepine, but did identify a marginal but significant increase in the rate of pre-term births in the experimental group.

Remeron is also a viable choice in breastfeeding women. Details are discussed elsewhere in the forum. As with every drug, the decision to use it is all about risk vs benefit. In this case, untreated depression represents a significant risk to both mother and baby. Have a look at this article for more information:

http://mommymeds.com/content/maternal-depression-pregnancy-and-breastfeeding

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD

The following references are cited in this response:

Djulus J, Koren G, Einarson TR, Wilton L, Shakir S, Diav-Citrin O, Kennedy D, Voyer Lavigne S, De Santis M, Einarson A. Exposure to mirtazapine during pregnancy: a prospective, comparative study of birth outcomes. J Clin Psychiatry. 2006 Aug;67(8):1280-4.