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Posted by Claudia Grazioso on December 12, 2011

SNRIs

We read a lot about Selective Serotonin Reuptake Inhibitors (SSRIs) and how these widely-prescribed antidepressants have been linked to birth defects (like craniosynostosis, infant omphalocele, cleft palate and Persistent Pulmonary Hypertension of the Newborn) and serious side effects (like withdrawal symptoms) for newborn infants whose mothers took them during pregnancy. But there is another group of antidepressants and anti-anxiety medication known as Serotonin Norepinephrine Reuptake Inhibitors (SNRIs). Though they aren’t in the news as much as SSRIs like Prozac, SNRIs are very widely-prescribed, as well. Currently, the SNRIs Cymbalta and Effexor are the eleventh- and twelfth-most commonly prescribed drugs. So if SNRIs are different from SSRIs, are they safer for pregnant women?

While SSRIs work on regulating serotonin in the brain, SNRIs work on regulating two neurotransmitters in the brain — serotonin and norepinephrine. Like SSRIs, they work to balance and regulate the levels of these chemicals to help alleviate symptoms of anxiety and depression. Some patients claim to feel fewer and less severe side effects when taking SNRIs.Unfortunately, as far as safety during pregnancy goes, that’s where the differences end.

SNRIs, like SSRIs, have been given a Pregnancy Category C rating by the Food and Drug Administration. That means that doctors and researchers feel that there is potential for these drugs to cause harm to developing human babies. Also, like many SSRIs, SNRIs seem to be the most dangerous when taken during the third trimester of pregnancy. Babies born to moms who took SNRI drugs during that time are at increased risk for experiencing neonatal withdrawal that can include feeding and breathing problems, as well as tremors and seizures. And babies born to moms who took SNRI drugs towards the end of their pregnancy are also at a significantly increased risk for PPHN. PPHN is a serious condition that requires hospitalization and often a lot of follow-up care to ensure the child can lead a healthy life.

Category C drugs are sometimes still prescribed to pregnant women when the benefits to the mother might outweigh the risks to the child. If you are pregnant and considering taking an SNRI drug, talk to your doctor about all of the risks involved.

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