Effexor during pregnancy?

[ThisMomentusDay]

Hi, I'm wondering if anyone has taken effexor(venlaflaxine) while pregnant?

My sister has just been advised to go back on hers, she's 16 weeks pregnant and stopped them when she discovered she was pregnant (about 9 wks)

I was shocked that the doctor (and she) did this as the risks are huge. I know you can't trust everything on the internet but even a glimpse at some sites about effexor in pregnancy are very scary. And even if there are no lasting effects the baby will still have to go through withdrawl when born.

So, have you or anyone you know taken effexor while pregnant and was the baby ok?

[fedupandtired]

Efexor's safety hasn't been established during pregnancy and as such it isn't recommended. There could be a good reason why her doctor has recommended it though and as always she should go with what her doctor says (I'm assuming we're talking a psychiatrist here and not a GP?)

There are safer alternatives. I switched from Efexor to amitriptyline when pregnant, under the advice of my psychatrist, and had no problems.

[Keziahhopes]

Whilst Effexor is unknown and a 2nd line AD, my psychiatrist several years ago told me to stay on it to ttc and so on. I didn't conceive on it thought. The hospital will have a peri-natal psychiatrist for her to ask if she only has a psychiatrist (ie not specialist in pregnancy).

[thingamajig]

Hi thisMomentousDay, when considering antidepressants during pregnancy, you have to balance the risks of not taking them with the risks of taking them - your sisters health is important too, and pregnancy is a classic time to become depressed if you are susceptible. She has tried to see if she can manage without them and obviously cannot. The risks to the fetus are not at all huge, and the effects on the baby, though they may require a shot stay in hospital, are not that bad. (I had a baby on citalopram and twins on citalopram + Lithium; both times we stayed in hosp for a week. ) I can't honestly say that their problems were due to withdrawal or just chance.
Breastfeeding can help mitigate any withdrawal effects, and your sister should not be put off breastfeeding because of taking it; I can't find any reports of adverse effects..
You should get your sister to ask her Dr to ask the hospital pharmacist for a report on Venlafaxine and pregnancy. Just because the back of a packet of pills says that a tablet cannot be taken in pregnancy does not mean that it is harmful, only that the drug company doesn't know that it isn't.

[ThisMomentusDay]

No, it's her GP that has put her back on them. (she hasn't seen a psychiatrist for years and is just medicated by her GP) And seems to have completely brushed over the possible side effects telling her baby will just have to have valium when born coz it'll be 'shaky'. This is her 2nd, she came off them straight away last time and stayed off them until baby was a few weeks old. We have had words about this as she wasn't happy with my response when she told me, even though i held my tongue and only asked was it safe! I just feel like the GP is being very blase (sp?) i know she may not want to startle her but surely she should be giving her all the info no matter how scary so that she can make an informed decision? When i asked was there nothing safer she could go on she said the GP said only prozac but that can cause heart defects so effexor was safer?!!

[thingamajig]

Why do you think that you know more than the GP about this? Just because you saw something on Google does not mean that you are an expert or have a balanced and professional view of a subject. It is pretty normal these days to have babies on SSRIs.
It is highly unlikely that your sisters baby will be ill enough to need valium, and so what if it does? As I say, after the first week my babies were like any other baby. If you sister finds that effexor treats her depression effectively, and the risk of her relapsing is great, and the risk of adverse effects are small why do you want her not to take it?
I would suggest you get off your sisters back and leave her choice of treatment to her and her doctor.

[ThisMomentusDay]

i'm not on her back at all and have not voiced any of my concerns to her as i don't want to worry her.

i do not think i know more than anyone if i did i wouldn't have asked the question in the 1st place, and i did not claim to have a professional or balanced view or to be any sort of expert

i have genuine concerns about my sister and her unborn child

i have no idea why u are so annoyed with me asking for this info or other people's experiences

i know how she was feeling having myself suffered with depression and i know she must have been desperate

[fedupandtired]

You're right to be concerned. There are safer antidepressants that she could take so why her GP would recommend one that's not had its safety proven is a bit baffling to be honest. Had my GP prescribed it when an experienced psychiatrist had said under no circumstances take it (which he did) then I'd be worried.

As for the poster who questioned about you thinking you know more about this than your sister's GP - well I consider myself more knowledgable than my GP when it comes to my mental health and what medicines are appropriate (and he agrees actually!). GP's aren't experts in either mental health or psychiatric medicines during pregnancy. Your sister needs referring to ensure she gets the most appropriate treatment (which may well be Efexor)

[Keziahhopes]

Hi - your sister seeing a psychiatrist, either normal one or a peri-natal one sounds really helpful for her and you, as they are experts on medication.

Hope all goes well for your family.

[UpsyDaisyDo]

I'm not pregnant but during a recent review of meds I told my psych that I was planning on TTC again (MMC in January) and he changed my ad's from venlafaxine (effexor) to Sertraline (Lustral).

[luckywinner]

If it helps, I am on 300mg of venlafaxine. I am also pregnant. I spoke with my psychiatrist at length about this as I did what you did and googled. Never Google! He said you have to weigh up the risks. Will your sister become worse if she stays off her meds? I know I would as I am barely in recovery. If you look at the NICE guidelines it says (and am paraphrasing here), if there is a risk to the mother that she will deteriorate, then it is better to keep her on the meds, and to monitor her closely throughout the pregnancy.

My psychiatrist also said you have to remember that there will be no evidence for anti-depressants and pregnant women as no drug company would ever run a trial like that. So you have to look retrospectively.

I hope this doesn't come across as insensitive but please try your best to keep these fears to yourself. My father in law (a GP himself) really really upset me recently questioning my mental health and my ability to look after another small baby. He also suggested that taking anti-depressants when pregnant was harming the baby. It is lovely that you want to look after your sister and that you are so concerned for her, she is lucky to have you supporting her. But my father in law left me sobbing and questioning my ability to cope.

Hope all the info helps.

[ThisMomentusDay]

Hi luckywinner Thank you for posting as you're the 1st person in the same situation as my sister. I will admit to being very shocked and upset(google's fault!!) when i 1st heard she was on them but when she told me herself i totally held my tongue as it's not my place to question her decisions and i didn't want to make her feel like she had to justify herself. What i am most concerned about now that i've calmed down and had time to think is that she won't be monitored any more closely than if she wasn't taking them, no extra scans, ante natal or GP appointments.

I'm feeling more and more annoyed at her GP as i feel she hasn't given her any options, posters on here have said how there are safer alternatives yet GP never told my sister this, she is under the impression there is no other option

And i don't know how to broach the subject with her as even though all i did was ask was there anything safer she could have taken she was upset by my reaction, i don't really know what i should have said. But i now feel like anything i do say to her she'll take the wrong way and i really don't want that.

Hope all goes ok for you :)

[thingamajig]

I don't know your sister's medical history, but Venlafaxine is usually used as a second line antidepressant, i.e. when the person has taken a different AD that failed to help previously. Different people respond better to different drugs, and often if an SSRI hasn't worked, a drug with a different method of action is needed, for example venlafaxine.
So changing her onto a new SSRI (generally considered safer), might not help her depression. And you want to be sure that whatever she does take will work, and effexor does work for her. So going back on the Venlafaxine may be seen as the only good option.

[luckywinner]

I think if you broach it in the way of questions she won't feel so ganged up on...eg, 'so has your gp offered you any extra monitoring through this pregnancy', and 'how do you feel about that?'. Ask her leading questions but make sure you leave them open-ended if that makes sense. You could then say to her 'because I was just wondering how you felt....'

My psychiatrist was very confident on me staying on them, as he believed there was more of a risk to me if I came off them, than to the baby if I stayed on them.

Google is the devil's work when it comes to health issues. But if you want a bit of reassurance look at the nice guidelines - they will be more balanced. I am guessing she knows and trusts her gp to help her make the right decision. Just think, these may even help her cope with what is anyway an incredibly stressful time. I wish I had been on something when my dc1 was born.

Lots of luck to her, and you. She sounds like she has someone looking out for her and I think that's some of the battle.

[oldwomanwholivesinashoe]

I have been on 450mg of venlafaxine for 3 years and have had 2 babies in this time. The only risk with venlafaxine is that the neonate might withdraw after delivery, but this is significantly reduced if you breastfeed. I saw psychiatrists and obstetricians during both my pregnancies and they were all happy with this. Both babies were perfect, no signs of withdrawals in either; daughter is now 2 and son just turned 1. I am still on venlafaxine, and if I got pregnant again, would keep taking it. The other option is to stop taking them, go through horrendous withdrawals, risk severe recurrence of depressive symptoms and even suicidal thoughts or end up resenting baby. Not worth it. I think anyone who is pregnant and on medication feels bad enough that their illness means they could potentially expose their baby to danger so asking them if they have considered alternatives is unhelpful. I know I would not have taken kindly to anyone suggesting that I wasn't considering all the options. Maybe seeing a psychiatrist as well as the GP would help put your fears to rest, but please rest assured that whatever you are worrying about, she has worried about but a hundred times more. She told you because she wanted your support, not your judgement.

[ThisMomentusDay]

not judging just worried