Venlafaxine

(Date: April 2020. 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?

Venlafaxine (Alventa®, Depefax®, Efexor®, Majoven®, Politid®, Sunveniz®, Venaxx®, Vencarm®, Venladex®, Venlalic®, Vensir®, Venzip®, ViePax®) is used to treat depression, anxiety, and panic disorder.

What are the benefits of taking venlafaxine?

Venlafaxine can prevent or reduce the unpleasant symptoms associated with some mental health conditions. This is important for good quality of life, and to ensure that a pregnant women remains well in preparation for looking after her baby.

Are there any risks of taking venlafaxine in pregnancy?

Most studies of pregnant women taking venlafaxine do not raise concern that it causes birth defects, stillbirth, preterm delivery, or low infant birth weight. However, for some pregnancy outcomes, only small numbers of women have been studied and ongoing research is ideally required. Studies investigating whether miscarriage may be more common following venlafaxine use have produced mixed findings, although the most reliable of these studies shows no increased chance of miscarriage.

Venlafaxine affects the central nervous system and can potentially cause short-term withdrawal symptoms in the newborn baby if taken in the weeks before delivery. Observation of your baby for a few days after birth may therefore be advised.

Medicines that work in a similar way to venlafaxine 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 venlafaxine 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.

There is no evidence that use of venlafaxine in pregnancy affects a child’s intelligence or behaviour. While this is reassuring, more studies are needed that follow children up to school age.

Are there any alternatives to taking venlafaxine?

Possibly. Other medicines can be used to treat depression, anxiety, and panic disorder. Some mental health problems can also be treated with talking therapies instead of medicines. However, this does not work for everyone and some people may prefer to take a medicine. If a woman’s condition is well-controlled with venlafaxine, it may be best to stay on it rather than try something new and risk a relapse.

Ideally, women planning a pregnancy should speak to their GP or specialist to determine whether venlafaxine is still the best option for them. Similarly, women who have an unplanned pregnancy while taking venlafaxine should be reviewed at the earliest opportunity by their GP or specialist.

What if I prefer not to take medicines during pregnancy?

It is very important that mental health problems are appropriately treated to ensure a woman’s wellbeing during pregnancy and while looking after her baby. Discontinuing venlafaxine can put you at risk of relapse and stopping abruptly can cause you to experience withdrawal symptoms. Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Please do not stop taking venlafaxine without first speaking to your 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 venlafaxine use in pregnancy.

Are there any risks to my baby if the father has taken venlafaxine?

We would not expect any increased risk to your baby if the father takes venlafaxine.

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

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system offers all pregnant women, and women who have been pregnant in the past, the opportunity to create their own digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.

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General information 

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.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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