Lexapro and Pregnancy
From LoveToKnow Pregnancy
If you're taking Lexapro and pregnancy is in your plans, you should talk to your doctor about the risks and benefits of continuing this medicine. Here's some basic information about the drug and its safety during pregnancy.
How Lexapro Works
Lexapro (generic name, escitalopram) is FDA-approved to treat depression and generalized anxiety disorder. Lexapro is a selective serotonin reuptake inhibitor (SSRI). Serotonin is a chemical, naturally produced by the brain, which regulates mood. Serotonin is released by nerve cells, is detected by receptors on other nerve cells, and then is taken back up into the cells again. SSRIs prevent that reuptake, forcing the serotonin to remain longer in the gap between cells. Although doctors don't fully understand why, the presence of that extra serotonin seems to help lift depression.
Lexapro and Pregnancy
The safety of SSRIs during pregnancy isn't fully established. Lexapro is labeled Pregnancy Category C, which means that there isn't enough research to show if it is safe for the fetus. For now, the FDA recommends taking Lexapro and other SSRIs during pregnancy only if the benefits outweigh the possibility of harm.
Pulmonary Hypertension
Lexapro and other SSRIs have been linked to a condition called Infant Persistent Pulmonary Hypertension (IPPH). IPPH involves abnormal blood flow through the heart and lungs. Babies with IPPH do not get enough oxygen to their bodies. This condition can be very serious, and babies with it may even die.
So far, studies have shown that babies born to mothers who took Lexapro or other SSRIs after the twentieth week of pregnancy were 6 times more likely to develop IPPH than babies of moms who did not take antidepressants. Check the FDA's web site for the most up-to-date information.
Other Risks of Lexapro and Pregnancy
Occasionally, babies born to moms who took Lexapro have had other problems, as well. Some babies have had to spend extra time in the hospital because they needed help with breathing and weren't eating properly. These problems have been observed in newborns whose mothers look Lexapro during the third trimester.
Other problems that may be linked to Lexapro and pregnancy include:
- Seizures
- Hypotonia ("floppy" arms and legs due to weak muscles)
- Hypertonia (stiff arms and legs)
- Hyperreflexia (fast reflexes which can signal neurological problems)
- Unstable body temperature
- Vomiting
- Low blood sugar
- Jitteriness
- Constant crying
Doctors think these effects could be due to withdrawal from the drug, but they may also be a direct effect of the drug itself.
Other Side Effects of Lexapro
Other side effects of Lexapro can occur whether or not you're pregnant. Most of these are rare, but they have been observed in people taking this drug or other SSRIs. Things to watch out for include:
- Suicidal thoughts or actions. This is most common when first starting the drug or changing the dose.
- Bleeding problems. The risk of abnormal, internal bleeding is higher when Lexapro is taken with aspirin, ibuprofen, or similar drugs.
- Mania. SSRIs can "unmask" manic depression, leading to hyperactivity, excitability, or an abnormally euphoric mood.
- Sexual problems. SSRIs can cause decreased sexual desire and make it difficult to have an orgasm.
- Insomnia. Some people who take Lexapro report difficulty sleeping. Others feel sleepy all the time.
- Increased sweating. SSRIs can cause sweat glands to become overactive.
Lexapro and Breastfeeding
Lexapro is found in the breast milk of new mothers who are taking the drug. It's not clear what effect this has on babies who breastfeed. There have been at least two reports of babies becoming overly sleepy, losing weight, and not feeding properly, but presumably there have been many more babies who had not problems at all.
As with Lexapro and pregnancy, it's best to talk the situation over with your doctor. If you must continue taking Lexapro, you may want to consider bottle feeding instead.
Stopping Lexapro
If you decide that, for you, Lexapro and pregnancy don't mix, you may want to stop taking the drug right away. This may not be a good idea, though. Doctors recommend tapering off Lexapro slowly, to avoid symptoms of withdrawal.
Stopping Lexapro abruptly can lead to problems including irritable or sad mood, mood swings, agitation, dizziness, strange feelings in skin or limbs, anxiety, confusion, insomnia, and headache.
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Comments
Leah, you'll need to find a doctor that is more in touch with you and sympathetic to your needs. It sounds like this doctor isn't taking the time to listen to you. Another doctor, perhaps an OB/GYN if you haven't already seen one, could be more helpful.
In a perfect world, doctors would like women to not take any medication while they are pregnant. But that's often not possible. Lexapro is a Class C drug, which means there isn't enough evidence to say if it's safe during pregnancy or not. Since it's a class C, the FDA advises that it should only be taken during pregnancy if the risks of not taking it are worse than the possible side effects of taking it. In your case, it sounds like you need to continue taking it, but you'll want to talk to another doctor.
It may be possible to put on a lower dose during pregnancy, too, but only with a doctor who is taking the time to work with you.
-- Contributed by: HollySwansonI am really concerned. I have been on all different types of medications. But now I have finally found one that works for me which is Lexapro. My husband and I have decided that we are going to start trying for children. We went to the Doctor to get a pre - natal check up. And he didnt explain anything to me, and told me to go off lexapro with out even stating way(the same centre that misdiagnosed me, said that I have bi -polar, which I don't). Told me to reduce it over six weeks which is what I did and I started to go completely insane, I would snap at my husband for no reason at all and we were arguing everynight it was horrible. Now I am back on it I have halfed my medication to 10mg every 2 days and I am fine. But we are both so frightened that something will happen if/when we fall pregnant. Please any advice welcomed.
-- Contributed by: LeahKerri, Lexapro is considered a Class C drug, meaning that there isn't enough evidence to determine whether or not it's safe. If your doctors think your mental health is going to be adversely effected by stopping the Lexapro, they must feel that the chances of it affecting a baby are slim.
If you still don't want to take the Lexapro, maybe there are other medications or treatment options your doctors can recommend.
-- Contributed by: HollySwansonThis page has been accessed 6,216 times. This page was last modified 13:58, 6 October 2008.
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