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Women's Health: Postpartum Community
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Avatar universal

medications during pregnancy

My husband and I are ready to have another baby, but due to postpartum with my last child I am taking wellbutrin and lexapro.
My family doctor told me that the lexapro was safe during pregnancy but not wellbutrin. My gynocologist said that wellbutrin was safe but not lexapro. I am very comfortable in the fact that I need to take something but don't want to harm an unborn baby. Who is right and who should I listen to?
4 Responses
Avatar universal
I found some info on wellbutrin, which is a class B pregnancy drug, which means: "NO EVIDENCE OF RISK IN HUMANS. Adequate, well-controlled studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals, or, in the absence of adequate human studies, animal studies show no fetal risk. The chance of fetal harm is remote, but remains a possibility."

"A. While there is information to support the use of certain antidepressants, including fluoxetine, citalopram and the tricyclic antidepressants, during pregnancy, there are much less data on the reproductive safety of bupropion (Wellbutrin). Information from the manufacturer (GlaxoSmithKline) includes 166 pregnancy outcomes involving first trimester exposure to this medication. There were 133 live births without birth defects, 22 spontaneous abortions, 8 elective terminations, and 3 infants born with birth defects. This represents a 2.1% risk of congenital malformation, which is consistent with what is observed in women with no known exposure. This information is reassuring; however, further studies on the reproductive safety of this medication are warranted.

Despite the lack of data, there may be certain situations when it is appropriate to use this medication during pregnancy. If a woman has had a poor response to serotonin reuptake inhibitors in the past but has had a good response to bupropion, one may consider re-initiating treatment with bupropion. This is done, of course in the context of an informed conversation with the patient, acknowledging the lack of extensive information regarding its reproductive safety. It is important to remember that untreated depression in the mother is not benign and may place both the mother and her children at risk. With regard to optimal dosage during pregnancy, the lowest effective dosage should be used. The dosage of medication needed to keep her well before pregnancy should be maintained across pregnancy, unless she develops symptoms of depression when pregnant, at which time the dose could be raised to insure mood stability."

And this about Lexapro, which is a pregnancy class C drug, meaning RISK CANNOT BE RULED OUT. Adequate,well-controlled human studies are lacking, and animal studies have shown a risk to the fetus or are lacking as well. There is a chance of fetal harm if the drug is administered during pregnancy; but the potential benefits may outweigh the potential risks.

"There are no adequate and well-controlled studies in pregnant women; therefore, escitalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Pregnancy-Nonteratogenic Effects

Neonates exposed to LEXAPRO and other SSRIs or SNRIs, late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These features are consistent with either a direct toxic effect of SSRIs and SNRIs or, possibly, a drug discontinuation syndrome. It should be noted that, in some cases, the clinical picture is consistent with serotonin syndrome (see WARNINGS).

When treating a pregnant woman with LEXAPRO during the third trimester, the physician should carefully consider the potential risks and benefits of treatment (see DOSAGE AND ADMINISTRATION).

Labor and Delivery

The effect of LEXAPRO on labor and delivery in humans is unknown."
  

So, Wellbutrin is a pregnancy class B drug, and Lexapro is a class C drug.  I am not a pharmacist or an MD, but it would appear that there is more info and studies regarding the use of Wellbutrin than Lexapro.

Hope this helps.  Here is a link:

http://www.perinatology.com/exposures/druglist.htm



Avatar universal
HI, WHAT DO YOU KNOW ABOUT PREGNANCY AND CLINDAMYCIN LOTION AND DIFFERIN CREAM , MY DERMATOLOGIST GAVE THESE TO ME AND I DID QUIT WHEN I WAS PG BUT AFTER THE D N C I STARTED UP AGAIN , I NEVER THOUGHT TO TELL THE DR I USED THEM FEW AND FAR BETWEEN, COULD THESE HAVE BEEN A CAUSE(MISCARRIAGE) DO YOU THINK? OR COULD THEY DO HARM NOW THAT IM TRYING AGAIN? YOUR A NURSE CORRECT I POSTED A ? TOO IF YOU WOULD HAVE ANY INSIGHT ON I WOULD APPRECIATE!! THANKS A BUNCH
LISA
Avatar universal
Unfortunately there is little actual information on Wellbutrin SR/Zyban (same drug)when it comes to pregnancy out on the
internet.  But there is some information available through the Freedom of Information Act as well as through GSK's Pregnancy
Registry (However, the registery is only sent to physicians and not to individuals.)

The following links contain information we have gathered from the FDA Medwatch as well as some of the clinical trials found in
the Zyban Summary Basis of Approval. (More to come in the coming months.) Animal studies were done at various dosing and
did show varying effects on the fetuses.  However, each is disregarded as exposure to maternal toxicity.  

In the MedWatch Report for Wellbutrin SR only (Nov 1, 1997- Feb 24, 2003), there are 163 reports of the mother's use of the
drug affected the fetus.  This figure as well as the total reports of fetal or congential defects equals 341.  However according to the GAO(Government Accounting Office), these figures only represent 1-10% of actual adverse reactions.

To view the information, go to:
http://geocities.com/borg_aw/articles/bupcongclintrial.htm
http://geocities.com/borg_aw/articles/fetuschildrensorted.htm


from http://www.perinatology.com/exposures/Drugs/Bupropion.htm
Bupropion (Wellbutrin
Avatar universal
Unfortunately there is little actual information on Wellbutrin SR/Zyban (same drug)when it comes to pregnancy out on the
internet.  But there is some information available through the Freedom of Information Act as well as through GSK's Pregnancy
Registry (However, the registery is only sent to physicians and not to individuals.)

The following links contain information we have gathered from the FDA Medwatch as well as some of the clinical trials found in
the Zyban Summary Basis of Approval. (More to come in the coming months.) Animal studies were done at various dosing and
did show varying effects on the fetuses.  However, each is disregarded as exposure to maternal toxicity.  

In the MedWatch Report for Wellbutrin SR only (Nov 1, 1997- Feb 24, 2003), there are 163 reports of the mother's use of the
drug affected the fetus.  This figure as well as the total reports of fetal or congential defects equals 341.  However according to the GAO(Government Accounting Office), these figures only represent 1-10% of actual adverse reactions.

To view the information, go to:
http://geocities.com/borg_aw/articles/bupcongclintrial.htm
http://geocities.com/borg_aw/articles/fetuschildrensorted.htm


from http://www.perinatology.com/exposures/Drugs/Bupropion.htm
Bupropion (Wellbutrin
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