If you are pregnant or thinking about becoming pregnant, it is important to closely examine your medications. Prescription medications that are otherwise safe and helpful may cause problems when you get pregnant. If you take Cymbalta, it is important to know how it can affect your pregnancy.
What Is Cymbalta?
Cymbalta is the brand name for duloextine, a type of serotonin-norepinephrine reuptake inhibitor. This medication is frequently prescribed for depression or anxiety. It can also be used for those with chronic nerve pain caused by conditions like fibromyalgia, arthritis, or diabetes. Cymbalta works by preventing serotonin and norepinephrine from leaving the brain as quickly. This allows more of these helpful neurotransmitters to linger in the brain, so it improves your mood, appetite, energy, and ability to sleep.
Has Cymbalta Been Tested for Pregnant Women?
Unfortunately, it is impossible to know the exact effect of Cymbalta on pregnancy without doing clinical trials. There are a lot of limitations placed on studying pregnant women’s reactions to various drugs. For all sorts of legal and ethical reasons, pregnant women are excluded from most types of prescription drug trials. This means doctors have not purposefully given Cymbalta to women in a controlled setting and then monitored test subjects to see what adverse effects arise.
Despite the lack of a carefully controlled test, it is still possible to learn a little about how Cymbalta affects pregnancies. Researchers have analyzed over 400 different women with a history of Cymbalta use to see whether their pregnancies were different from women who did not use Cymbalta. Though surveys and medical database information are not as conclusive as medical trials, they still provide a lot of valid, scientifically sound information about what Cymbalta may do to a pregnancy.
Cymbalta Can Make Your Pregnancy More Dangerous
Compared to some other types of drugs, Cymbalta is not disastrously unsafe to use while pregnant. However, this does not mean that it is entirely safe. Data indicates that Cymbalta can very slightly increase certain adverse effects for pregnant women. It is important to be aware of this potential because it can affect how you handle your pregnancy.
Women who take Cymbalta are around 1.12 to 1.67 times as likely to experience preeclampsia. This is a potentially dangerous pregnancy complication that starts out with abnormally high blood pressure. Though many women with preeclampsia give birth safely, the unusually high blood pressure can damage the liver or blood cells. In these cases, preeclampsia may cause stillbirths or be fatal to the mother.
Another potential issue to be aware of is hemorrhages. Women exposed to Cymbalta have a slightly higher risk of postpartum hemorrhage, or excessive bleeding following childbirth. This can be very dangerous, especially if the mother has preexisting health conditions. Without prompt treatment, postpartum hemorrhages can be life-threatening.
Cymbalta May Harm Fetal Development
In addition to potentially causing problems with the mother’s health, Cymbalta may also affect the growth of the fetus. These problems can potentially end the pregnancy. Data suggests that the rate of spontaneous miscarriage is around 18% for those who take Cymbalta, which is 3% higher than the general population’s rate. Even if the pregnancy does not end too early for the fetus to survive, Cymbalta use is linked to slightly higher risks of preterm births and lower than usual birth weights.
Furthermore, in successful pregnancies, Cymbalta exposure was linked to slightly higher than average rates of congenital malformations. The most common types of congenital malformations were related to the urinary tract system, with some children having kidney and urinary issues. Some other malformations noted were clubfoot and cardiovascular abnormalities. Of course, without extensive research, it is impossible to tell if the Cymbalta is directly causing the issues, but it is something that women should be aware of.
Should You Take Cymbalta While Pregnant?
With all the potential risks of Cymbalta, it can be hard for women to decide if they want to take the medication while pregnant. There is no simple answer to whether or not Cymbalta is safe. Instead, it is a decision that must be made on a case-by-case basis. Women will need to consult carefully with their doctor to decide whether or not the risks outweigh the benefits.
For some women, the idea of doing anything to potentially harm their pregnancy is unacceptable. Because there may be some slightly elevated chances of harm to the mother and child, many women may discontinue Cymbalta use because they feel that it is better to be safe than sorry. Especially in mothers at risk for preeclampsia, Cymbalta use can be somewhat risky.
However, Cymbalta is used to treat some very serious medical conditions, so discontinuing it can be difficult. In cases of severe depression, the risks to the mental health of the mother may be very high. Stopping antidepressant use could potentially cause self-harm, suicidal thoughts, and other actions that harm the pregnancy even more. In these situations, a doctor might recommend continuing to take Cymbalta.
Altogether, the FDA has placed Cymbalta in the “category C” section of their pregnancy recommendations. A category C drug is a drug that has been shown to cause adverse effects in animal studies, but there have been no adequate studies on the drug’s effect on humans. Therefore, the FDA states that the potential benefits of Cymbalta might make it worth using despite some of the potential risks.
What Should Cymbalta Users Do If They Just Found Out That They Are Pregnant?
If you use Cymbalta and have just realized that you are pregnant, it is not a good idea to abruptly discontinue use without talking to your doctor. Stopping Cymbalta suddenly can cause withdrawal symptoms, including headaches, nausea, and vomiting. Furthermore, discontinuing antidepressant use suddenly can cause a relapse of depression, anxiety, and other symptoms.
Therefore, it is always a good idea to talk to your doctor about Cymbalta’s effect on pregnancy. As soon as you realize that you are pregnant, schedule appointments with your current doctors and an OB-GYN so that you can discuss how your medication regimen is affecting your pregnancy. Depending on your situation, your doctor might suggest you try tapering off of Cymbalta, or they may tell you to keep using it.
The good news is that the risks of complications are fairly rare. Even though Cymbalta may cause some issues, the majority of women who take Cymbalta while pregnant still have successful outcomes. Therefore, there is no reason to panic and assume that you have harmed your fetus just because you took Cymbalta without realizing that you are pregnant.
Should You Discontinue Usage Before Getting Pregnant?
So far, the evidence suggests that Cymbalta use can cause the same problems regardless of whether it is taken at the beginning or end of pregnancy. Therefore, it is a good idea to avoid Cymbalta during the early stages of pregnancy if possible. In many cases, it can take a month or two for a woman to realize that she is pregnant, so it is possible that a prospective mother may take Cymbalta without realizing that she has conceived.
To prevent this from happening, it can be helpful to discontinue Cymbalta use before you actually conceive. Of course, any decisions should be made in conjunction with your doctor’s recommendations, but you might want to consider quitting Cymbalta once you choose to start trying for a pregnancy. This can keep Cymbalta from causing any issues while your fetus is developing.
Discontinuing use before pregnancy is also helpful because it gives you more time to find another alternative. Pregnancy is a volatile time, filled with a lot of stress, hormonal changes, and intense emotions. Having to abruptly quit your antidepressants during this time can cause more mental strain. By stopping Cymbalta and working on other treatments beforehand, you may be able to ensure that your pregnancy goes more smoothly.
How to Use Cymbalta Safely During Pregnancy
If you do need to continue using Cymbalta while pregnant, there are some things you may be able to do to reduce the risk of adverse effects. First of all, your doctor may suggest changing your dose. Instead of multiple medications, your doctor may recommend you try switching to just using a single antidepressant. They will typically suggest taking the lowest dosage possible. You may currently be on the lowest dose of Cymbalta you can tolerate, but for some patients, lowering their dosage during pregnancy can be helpful.
In addition to adjusting your dosage, your doctor will need to carefully monitor your health. They may prescribe bed rest or other preventative measures to prevent problems from happening. If you display any symptoms of preeclampsia, you may need additional monitoring. Your doctor may recommend things to help with blood pressure, such as blood pressure medication. In some cases, they may recommend inducing an early delivery.
Alternatives to Using Cymbalta While Pregnant
If you do decide to quit using Cymbalta while you are pregnant, you have several different options. Depending on your condition, your doctor may suggest other medications, therapy, or some other potential treatments. It can take some time to find a safe and effective alternative, so you should start discussing discontinuing Cymbalta as soon as possible.
One of your first options is exploring other antidepressants. Cymbalta is a type of SNRI, which is generally considered safe during pregnancy, but certain types of SSRIs, like citalopram and sertraline, might be slightly safer. These medications can cause premature birth and maternal birth changes, but they do not cause birth defects.
Your other option is focusing on treating anxiety and depression with counseling and therapy. Most people dealing with mental health problems can benefit from a combination of therapy and medication in the first place. When medication is not an option because of pregnancy, additional therapy might be required. Though therapy does not replace medication, it can help. Speaking to a counselor regularly can help you find skills for managing the mental health symptoms that you experience without Cymbalta.
Granite Recovery Center Is Here to Help
If you have been using Cymbalta as part of your substance use disorder treatment, it is important to talk to your doctor about potential pregnancies. Pregnancy is a vulnerable time during recovery, so it is important to have support from substance abuse counselors. At Granite Recovery Center, our team has plenty of experience addressing these sorts of unique needs. We can discuss whether Cymbalta use is right for you and assist you with exploring other treatment options.
Granite Recovery Center provides a wide variety of treatment options throughout the New England area. Our treatments focus on evidence-based clinical therapies, but we also provide medication-assisted treatment and holistic therapies. You can choose from a variety of treatment schedules, including both inpatient and outpatient options. Some of our patients live in our residential clinic for full-time care while others in our aftercare program just visit us occasionally. If you would like to learn more about all of our treatment options, give us a call today.