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hi. with my first pregnancy i had initially weaned off the paxil cr. unfortunately my anxiety symptoms were not controlled and i was started on zoloft as it was the safest drug during pregnancy. zoloft did not work and i was switched back to paxil at around 16 weeks. I currently still take paxil 25mg cr daily while breastfeeding. i am concerned about my next pregnancy. should i wean off the paxil until im out of the 1st trimester? i was told that is the highest risk of deformity and side effects with taking the medication. thank you
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Dear Saki14,
This is a pregnancy category D (possibly hazardous medication)
Experience with this drug in pregnant women has demonstrated that it can cause birth defects. The benefits to the mother might exceed the possible risks to the fetus. Epidemiological studies have shown that infants born to women who had first trimester paroxetine exposure had an increased risk of cardiovascular malformations, primarily ventricular and atrial septal defects (VSDs and ASDs). This study also suggested an increased risk of overall major congenital malformations (inclusive of the cardiovascular defects) for paroxetine compared to other antidepressants.
I would suggest you talk to your obstetrician, and consider stopping it for the first trimester at least.
Tassneem Abdel Karim, MD
InfantRisk Center
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