Duloxetine
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Duloxetine can be used in pregnancy if it is needed to control depression, anxiety, or neuropathic pain.
What is it?
Duloxetine (Cymbalta®, Yentreve®) is used to treat depression, anxiety, and neuropathic pain.
Benefits
What are the benefits of taking duloxetine in pregnancy?
Duloxetine improves your mood and feelings of wellbeing. It is very important that mental health conditions are well-treated to ensure a woman is well during pregnancy and while looking after her baby.
Duloxetine can also treat neuropathic pain and can therefore be important for normal function and quality of life.
Risks
Are there any risks of taking duloxetine during pregnancy?
There is no evidence that use of duloxetine in pregnancy causes miscarriage, birth defects, stillbirth, preterm birth, or low infant birth weight.
Duloxetine can potentially cause short-term withdrawal symptoms in the newborn baby if taken in the weeks before delivery. Medicines that work in a similar way to duloxetine have been linked in rare cases to a lung problem in newborn babies called persistent pulmonary hypertension of the newborn (PPHN). There is no good information on whether duloxetine use around the time of delivery increases the chance of PPHN. As a precaution, your baby will be checked for breathing problems by a midwife or paediatrician.
Alternatives
Are there any alternatives to taking duloxetine?
Possibly. Other medicines can be used to treat mental health conditions and pain, so switching may be an option. For some people, talking therapies can be helpful, but this does not work for everyone, and some may prefer to take a medicine. If a woman’s condition is well-controlled with duloxetine, it may be best to stay on it rather than try something new and risk a relapse.
Ideally, a woman planning a pregnancy should speak to her GP or specialist to determine whether duloxetine is still the best option. Similarly, women who have an unplanned pregnancy while taking duloxetine should be reviewed at the earliest opportunity by their GP or specialist.
No treatment
What if I prefer not to take medicines during pregnancy?
It is very important that mental health conditions and neuropathic pain are well-controlled during pregnancy. Discontinuing antidepressant medication can cause symptoms to return and stopping suddenly can cause withdrawal symptoms. A medicine will only be prescribed during pregnancy if it is absolutely necessary, and a doctor or specialist will be happy to discuss the benefits and any risks.
Please do not stop duloxetine without speaking to your midwife, GP, or specialist.
Will my baby need extra monitoring?
All pregnant women in the UK should be offered a detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. No extra monitoring for major birth defects is required following duloxetine use in pregnancy.
Are there any risks to my baby if the father has taken duloxetine?
We would not expect any increased risk to the baby if the father took duloxetine 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.