Pristiq During Third Trimester and Birth Defects

November 20, 2012 — Pristiq (desvenlafaxine) is an antidepressant medication that is associated with many reports of birth defects in infants who were exposed to Pristiq during the third trimester.

The manufacturer of Pristiq has placed specific warnings about a “direct toxic effect” of Pristiq on fetal development. Even so, the U.S. Food and Drug Administration (FDA) classifies Pristiq as a “Pregnancy Category C” drug, which means that it may still be prescribed if the benefits outweigh any potential risks.

Pristiq is an antidepressant that targets two neurotransmitters: serotonin and norepinephrine. These neurotransmitters are involved in regulating moods and emotions. They are also important during fetal development. When Pristiq is used by pregnant women, it may influence fetal development or increase the risk of complications at birth.

Experts do not fully understand the risks associated with Pristiq and pregnancy because no adequate or well-controlled studies have ever been conducted of Pristiq in pregnant women. This is because it would be unethical to randomly prescribe Pristiq or placebos to pregnant women. Therefore, the manufacturer warns that “Pristiq should be used during pregnancy only if the potential benefits justify the potential risks.”

The potential risks are serious enough that the manufacturer has placed specific warnings about the risk of using Pristiq during the third trimester. These warnings state:

“Neonates exposed to SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), or SSRIs (Selective Serotonin Reuptake Inhibitors), late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery.”