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Paxil in Pregnancy

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This is a summary of some info that GSK has released to day regarding Paxil in pregnancy:

(Again--PLEASE do not stop taking any med on your own, or cold turkey. PLEASE make sure your OB and your pdoc work together on your treatment--THIS IS FOR INFORMATION ONLY!!!) The risk appears to be very low--and your doctors, working TOGETHER with you, will help you decide what you should do.

Often, untreated depression is MUCH more dangerous during pregnancy than using an antidepressant thay is being monitored by your OB AND your pdoc together.

china--

Drugmaker GlaxoSmithKline has sent a warning letter to doctors, advising that the antidepressant Paxil may be linked to a slightly higher risk of birth defects in babies exposed to the drug during the first trimester of pregnancy. The company also has added the warning to its Paxil label. This comes on the heel of a new study requested by the Food and Drug Administration.

Glaxo described the findings as a surprise. Other studies had shown no increase in birth defects. In the latest study, the company looked at data from more than 3,500 pregnant women taking antidepressants. It found four percent of the women taking Paxil had babies born with birth defects, compared to two percent taking other antidepressants. For comparison, the rate of birth defects in the general population is about three percent. In this study, the most common birth defects with Paxil were heart problems.

The FDA's Dr. Sandra Kweder says the agency had requested the study, but it also was surprised by the results. "It does conflict with other information that's been available," she said. "For that reason, we decided better to be safe and put that information out there."

The FDA has posted Glaxo's letter on its Web site, but Kweder adds the Paxil label has always warned doctors to weigh the potential risks and benefits of prescribing drugs in this class during pregnancy.

Dr. Lee Cohen, a perinatal psychiatrist at Massachusetts General Hospital, cautions that the new findings don't mean pregnant women who are currently taking Paxil should stop taking the drug. Exposing a baby to the mother's depression is also a health risk, he says. Women who are depressed don't take as good care of themselves, says Cohen, and are more likely to use drugs and alcohol, eat poorly and miss prenatal appointments. Research also suggests that women with depressive symptoms during pregnancy have children with lower birth weights.

Last year, another warning about antidepressants and pregnancy was issued: babies exposed to the drugs at the end of pregnancy could suffer from withdrawal. Dr. Sandy Zeskind, who directs neurodevelopmental research at the Carolinas Medical Center, says the latest study on Paxil shows there's a need for further research on antidepressants and pregnancy.

The FDA plans to review the new information about Paxil and pregnancy over the next few months to decide whether the additional warning on the label is sufficient.

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Hi All:

when i first learned i was preggers....I did a whole bunch of research on the meds i was taking and how that would affect pregnancy.

and i quickly realized that my mental health is more important right now. if i were to stop paxil - I'd be suicidal within 2 days. I know this very well as at the beginning of taking paxil i wasnt getting my refills on time (mostly my fault) and i would get horribly suicidal.

so....i think it is best for me to continue on the paxil. there are so many other statistics regarding things that could happen to the embryo/fetus. The chances of me having a down syndrome kid are much higher than any risk from paxil.

and as ive said - if my baby is born with 5 arms and 3 eyes - I'll still love baby just the same.

db

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You, dear mama, are a perfect example of what I am always preaching about--I am assuming your OB and pdoc are both aware of your medications, history, etc.

I wish I could have this put on a billboard in every town--UNTREATED DEPRESSION BEFORE AND AFTER PREGNANCY IS VERY DANGEROUS TO MAMA AND BABY!!!!! Please be sure you have an OB who is knowledgable and will work as a team with your pdoc.

End of lecture for the day--

love, china (can I be the honorary grand-momma??)

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Hi All:

China - thanks for the compliment. and to those that dont know - my pdoc & ob-gyn are very aware of the siutation. pdoc now sees me about every 2 weeks instead of once a month in order to help me with my bipolar & meds. ob-gyn is realtively comfortable with my meds - he was most concerned about xanax and that its addictive.

of course you can be my baby's cb grandma.

and faith can be an auntie.

love,

december

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Guest Jessa

I agree 110%. And I want to be an auntie ;)

China I was told you wer ethe on to ask this: Do you knwo about lexapro adn pregnancy? it is teh only thign that has worked for me I haev really bad ocd and panic disoder. I wnat to have achild, my doctor said prozac was better during preg... But I relaly dont' wnat to switchy?? WHat have to read or heard??

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FWIW I have OCD and took prozac for a while and it did help. I think most people who have gotten relief from OCD with it have had to take fairly high doses, but it should help one it gets going. I think I started at 80mgs and increased it at least one time.

This should answer your questions:

http://www.otispregnancy.org/pdf/paxil.pdf

If you were to change you'd have to deal with paxil discontinuation and then wait six weeks for the prozac to kick in during which time you'd be running around with untreated panic and OCD. It's not uncommon for OCD to get worse during pregnancy anyway. There is inconclusive evidence that paxil might increase the chance of being born with a heart defect by 1%. Meanwhile, the evidence for untreated depression and anxiety is much more solid.

http://bjp.rcpsych.org/cgi/content/full/180/5/389

http://www.womensmentalhealth.org/topics/P..._depression.pdf

I'm not any kind of medical professional. I am, however, a gambling man. I can tell you which bet I think looks safer.

There's tons more information here if you want to dig in:

http://www.womensmentalhealth.org/topics/pregnancy_lib.html

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