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Is Pristiq Safe During Pregnancy?


November 20, 2012 — If you are pregnant or thinking about becoming pregnant, talk to your doctor about the potential risks and benefits of using Pristiq (desvenlafaxine) during pregnancy.

Although Pristiq is associated with birth defects and complications, untreated depression can also cause serious harm to a developing fetus. Depression is a serious illness, and the decision about how to treat depression during pregnancy should be discussed with a trained healthcare professional.

Pristiq is a “Pregnancy Category C” medication, which means that it could potentially cause birth defects, but no one knows the exact risks because there are no well-controlled studies of Pristiq in pregnant women. The manufacturer warns that Pristiq should not be used during pregnancy unless the potential benefits outweigh any potential risks.

In the first trimester of pregnancy, Pristiq could potentially increase the risk of birth defects by adversely influencing the fetal serotonin system. Pristiq works by influencing serotonin, which is a neurotransmitter in the brain that also influences fetal development (especially heart development). Some scientists hypothesize that a medication that disrupts serotonin signaling could plausibly cause a heart defect.

There are also serious risks of using Pristiq during the third trimester. Even the manufacturer warns about the “direct toxic effect” of antidepressants late in pregnancy. Researchers have found that up to one-third of fetuses exposed to an antidepressant show symptoms of drug withdrawal, including seizures, breathing problems, feeding difficulties, constant crying, tremors, and more.

Very few studies have specifically investigated Pristiq and pregnancy. More than a dozen studies have linked other antidepressants (SSRIs, such as Prozac, Zoloft, Celexa, and Lexapro) to an increased risk of birth defects. Because the SSRIs and Pristiq both influence serotonin, it is possible that both classes of drugs have similar effects on fetal development.


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