(Date of issue: March 2014. Version: 2)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
What is it?
Trazodone (Molipaxin®) is a medicine that acts on the brain and nerves and is used to treat anxiety and depression.
Is it safe to take trazodone in pregnancy?
There is no yes or no answer to this question. When deciding whether or not to take trazodone during pregnancy it is important to weigh up how necessary trazodone is to your health against the possible risks to you or your baby, some of which will depend on how many weeks pregnant you are. Remaining well is particularly important during pregnancy and while caring for a baby. For some women treatment with trazodone in pregnancy may be necessary.
This leaflet summarises the scientific studies relating to the effects of trazodone on a baby in the womb. It is advisable to consider this information before taking trazodone if you are pregnant.
Your doctor is the best person to help you decide what is right for you and your baby.
What if I have already taken trazodone during pregnancy?
If you have taken or are taking any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and, if so, to make sure that you are taking the lowest dose that works and only for as long as you need to.
It is very important that you do not suddenly stop taking trazodone as this could be dangerous to you, and also to your baby if you are already pregnant. Do not make any change to your medication without first talking to your doctor.
Can taking trazodone in pregnancy cause birth defects in the baby?
A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.
Around 180 women who took trazodone during early pregnancy have been studied. These women were not at a higher risk of having a baby with a birth defect than women who didn’t take trazodone. However, a much larger number of pregnancies need to be studied before we can say whether or not taking trazodone in pregnancy increases the chance of birth defects in the baby.
Can taking trazodone in pregnancy cause miscarriage, stillbirth, or my baby to be small at birth (low birth weight)?
No increased risk of miscarriage, stillbirth, or of having a low birth weight baby was seen in women who had taken trazodone or a related medicine during pregnancy in the one study which investigated these problems. However, because only small numbers of pregnant women taking trazodone have been studied and most of these women took trazodone in the early stages of pregnancy only, more information needs to be collected.
Can taking trazodone in pregnancy cause preterm birth?
No evidence that taking trazodone during pregnancy causes a woman to give birth early (before 37 weeks of pregnancy) was provided by either of the two studies which analysed this. However, in the first of these studies only a small number of the women carried on taking trazodone or a related medicine after the first trimester. The second study analysed a small number of women taking trazodone near the end of pregnancy. Because only small numbers of women have been studied, particularly those who took trazodone later in pregnancy, more research is required.
Can taking trazodone in pregnancy cause other health problems in the child?
Withdrawal symptoms at birth (‘neonatal withdrawal’)
Withdrawal symptoms are thought to occur as the newborn baby’s body has to adapt to no longer getting certain types of medicines through the placenta.
Because trazodone has not been studied specifically there is no scientific information as to whether taking trazodone in pregnancy could cause a baby to experience withdrawal symptoms.
However, because trazodone is similar to other medicines that are known to cause neonatal withdrawal, close monitoring of your baby for a few days after birth may be advised if you have taken trazodone regularly in the weeks before delivery.
Learning and behavioural problems
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.
No studies have been carried out to look at whether there is an increased risk of learning and behavioural problems such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in children who were exposed to trazodone while in the womb.
Will my baby need extra monitoring?
Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine antenatal care. Taking trazodone in pregnancy would not normally require extra monitoring of your baby.
If you have taken trazodone around the time of delivery your baby may require extra monitoring after birth because of the possible risk of neonatal withdrawal.
Are there any risks to my baby if the father has taken trazodone?
We would not expect any increased risk to your baby if the father took trazodone before or around the time you became pregnant.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.