SNRIs and Pregnancy

In clinical studies on SNRIs and pregnancy, the antidepressants caused problems when they were given to pregnant women who were in their third trimester of pregnancy. Newborns who were exposed to the drugs during late pregnancy experienced a number of problems, including lack of oxygen in the blood, difficulty breathing, and seizures. Because of these possible risks, talk to your healthcare provider immediately if you are taking SNRIs and pregnancy occurs.

 

Are SNRIs Safe During Pregnancy? -- An Overview

For women who are pregnant, SNRIs (serotonin-norepinephrine reuptake inhibitors) may not be safe. This is based on human and animal studies that looked at the effects of SNRIs during pregnancy.
 

SNRIs and Pregnancy Category C

The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category C is given to medicines that show side effects to the fetus in animal studies but have not been adequately studied in pregnant humans. A pregnancy Category C medicine may still be given to a pregnant woman if the healthcare provider believes that the benefits to the pregnant woman outweigh the possible risks to the unborn child.
 
SNRIs are all pregnancy Category C medications, generally due to third trimester concerns.
 

SNRIs and Pregnancy: Third Trimester Concerns

There have been reports where fetuses being exposed to SNRIs during the third trimester of pregnancy develop complications that require hospitalization, respiratory support, and/or tube feeding.
 These newborns experienced a number of symptoms, including:
 
  • Difficulty breathing
  • Seizures
  • Lack of oxygen in the blood
  • Feeding difficulties
  • Tremors
  • Irritability
  • Constant crying.
     
Also, babies who are exposed to SNRIs during late pregnancy are also at increased risk for developing persistent pulmonary hypertension of the newborn (PPHN). PPHN is associated with significant complications and even death. Women who take an SNRI after week 20 of pregnancy have a sixfold increase of delivering a baby with PPHN.
 
(SNRIs and Pregnancy Continued: Page 2)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;