Is It Safe to Take Venlafaxine While Pregnant?

When you’re pregnant, you'll want to make sure you keep your baby as safe and healthy as possible. That means making sure you stay healthy too.

Using medications during pregnancy is common, for a variety of different conditions. But it's not always easy to know which medications are safe. 

The number of people who take antidepressant medication is on the rise, especially among women, so you might wonder if it’s safe to use antidepressants while pregnant. Are certain medications, like venlafaxine, okay to take?

Venlafaxine — the generic brand of the medication Effexor® — is a commonly prescribed antidepressant. Research has shown venlafaxine to be effective for treating depression and anxiety.

If you struggle with anxiety or depression during pregnancy, you may wonder what side effects taking venlafaxine will have, especially for your baby.

We’ll go over the basics of venlafaxine and how this medication works and whether venlafaxine in pregnancy is safe.

Venlafaxine is an antidepressant medication belonging to the class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs).

This particular medication works by increasing levels of the chemicals serotonin, norepinephrine and dopamine — all of which can affect mood, thoughts and behavior.

Venlafaxine is used to treat several mental health conditions such as:

• Major depressive disorder. Also known as major depression or depression, this disorder is characterized by a consistent low, depressed mood and lack of interest in normal activities.

• Generalized anxiety disorder. A condition of excessive worrying that’s difficult to control.

• Social anxiety disorder. Also known as social phobia, this condition is an extreme fear of interacting with others that interferes with daily life.

• Panic disorder. This particular disorder consists of unexpected attacks of extreme worry and fear.
  

Healthcare providers may also prescribe venlafaxine “off-label” to treat mental health conditions such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD) and to prevent migraines, among other uses.

There can be side effects of venlafaxine, including:

• Dizziness

• Drowsiness

• Headaches

• Nausea

• Vomiting

• Stomach pain

• Constipation

• Dry mouth

• Loss of appetite

• Weight loss

• Pain, numbness or tingling in parts of the body

• Difficulty urinating

• Signs of infection, such as chills or sore throat

• Decreased sex drive
  

There can also be more serious side effects from taking venlafaxine such as chest pain, difficulty breathing, seizures, irregular heartbeat, unusual bruising or bleeding, hallucinations, coordination problems and coma.

If you currently take venlafaxine or Effexor®, you should let a health care provider know if you experience any of these adverse effects or if the more common side effects last more than a few weeks.

If you’re pregnant or are planning to become pregnant, you may be wondering whether venlafaxine during pregnancy is safe.

You should let your healthcare provider know if you’re pregnant or plan to become pregnant and have been diagnosed with anxiety or depression, as there are both risks and benefits of taking venlafaxine during pregnancy.

Keep reading for more information about taking venlafaxine while pregnant.

If you need treatment for anxiety or depression during pregnancy, is it safe to take venlafaxine?

If you already take venlafaxine for depression and become pregnant, there could be risks or benefits, depending on your condition.

You may also want to know during which stages of pregnancy venlafaxine may affect your fetus.

Can Venlafaxine Affect Fertility?

If you’re trying to get pregnant, whether or not venlafaxine affects your chances of conceiving is good information to know.

A 2016 study suggested that taking antidepressants — selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) or tricyclic antidepressants (TCAs) for example — might reduce fertility for women with depression or anxiety.

However, the study couldn’t determine if the reduced chances of conceiving were from the antidepressants or from the depression itself.

Another study from Sweden found that a small percentage of women with depression or anxiety undergoing in vitro fertilization (IVF) while taking antidepressants — such as selective serotonin reuptake inhibitors and others — had slightly less success in becoming pregnant.

Those who had anxiety or depression but weren’t taking antidepressants, however, had even less success becoming pregnant through IVF, suggesting that untreated depression may be a cause instead.

While it may or may not impact the chances of getting pregnant, you might question if taking venlafaxine during pregnancy is safe.

Taking Venlafaxine During Pregnancy

You may have already been diagnosed with depression when you become pregnant. There’s also a chance of developing depression during pregnancy, a maternal depression known as perinatal depression.

This type of maternal depression mostly affects women during pregnancy, although sometimes it can develop after you give birth.

If you’re diagnosed with perinatal depression, a healthcare provider will likely treat this type of depression with the same tools available for treating major depression and other depressive disorders — typically medication such as venlafaxine, therapy or a combination of both.

But is venlafaxine during pregnancy safe and what are the potential side effects?

Research is mixed on whether taking venlafaxine while pregnant results in birth defects (also called congenital malformations) or other health issues and adverse pregnancy effects.

Generally, all pregnant women have a three percent chance of having a baby born with a birth defect.

A study of 150 pregnant women who took venlafaxine found a similar level of risk of birth defects in this group — a three percent risk of congenital malformations.

But another study published in JAMA Psychiatry found that taking venlafaxine early in the pregnancy resulted in a higher risk of birth defects than taking other antidepressants during pregnancy.

The study found some of the most common congenital malformations from exposure to venlafaxine during pregnancy included defects of the heart, brain, spine, abdominal wall and lip or roof of the mouth (a cleft lip or cleft palate).

Another study of the effects of prenatal exposure to venlafaxine early on in pregnancy found similar defects of the cleft palate, as well as birth defects of the heart and other congenital malformations.

However, both studies acknowledge that more research is needed due to the small number of women tested and the fact that it’s unclear if the underlying risks of depression had an effect.

Cardiovascular defects or congenital heart defects were also found to be a possible birth defect in a 14-year study across a group of pregnant women from Denmark, Sweden, Finland, Iceland and Norway who took venlafaxine or an SSRI. While the percentage of babies born with cardiac defects after exposure to venlafaxine or an SSRI was relatively low at 1.5 percent, the researchers said that antidepressants were associated with a higher risk of cardiac birth defects.

However, after confidence intervals and confounding factors were taken into account, the researchers concluded that they did not find a significant association between venlafaxine and birth defects.

Also, the number of babies born with cardiovascular defects was only marginally higher than the 1.2 percent of babies with cardiovascular defects who were born to mothers who didn’t take antidepressants while pregnant.

Similarly, a large population-based study found the risk of cardiovascular birth defects to be low, although this was across the use of several different antidepressants in pregnancy.

Many women develop peripartum or perinatal depression during pregnancy or after giving birth.

When a woman develops depression either a few weeks or months after giving birth, this is called peripartum or postpartum depression (although these can also occur during pregnancy).

Mothers with perinatal or peripartum depression feel extreme sadness, guilt, anxiety or fatigue that interferes with their day and caring for themselves or others.

Cases of perinatal depression can range from mild to severe and may even be severe enough to affect the health of the mother and baby.

A review of several studies has found that pregnant women with depression also have an increased risk of delivering babies prematurely and at low birth weight.

Depression during pregnancy can have some other harmful effects on both you and your baby, from interfering with caring for yourself or your baby and bonding with your baby to an increased risk of using alcohol, tobacco and other harmful substances.

To help you and your baby avoid these potential health problems, a healthcare provider may recommend perinatal depression treatment options that are similar to those used to treat other depressive disorders, such as the use of antidepressants and therapy.

If you’ve been taking venlafaxine before you got pregnant, discontinuing the use of the medication can also have an impact.

Studies have shown that 68 percent of women who stopped using antidepressants during their pregnancies experienced a relapse of depressive symptoms.

So, is it safe to take venlafaxine while you’re pregnant?

There are both risks and benefits to taking venlafaxine or antidepressants like selective serotonin reuptake inhibitors while pregnant. There’s a balance between the potential risks of treatment using venlafaxine and the risks of not treating depression while pregnant.

While there’s evidence that taking venlafaxine during pregnancy has a risk for birth defects and other side effects, the number of defects was small.

There’s also evidence that untreated depression while pregnant can affect not only the mother’s health but the baby’s as well, impacting birth weight and the risk of preterm delivery, which can cause other health issues.

The best course of action is to talk with your healthcare provider about the risks and benefits of taking venlafaxine while pregnant, as well as your anxiety or depressive symptoms. They can help figure out the best treatment plan for you and your baby.

The benefits of therapy for anxiety and depression make it another good treatment option. You can connect with a mental health professional online to talk about your condition, your pregnancy and more to find what treatment could be helpful.

Remember that taking care of yourself is taking care of your baby.