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Use of Cymbalta during pregnancy for depression may result in a risk of heart malformations for the baby, and lead to increased postpartum hemorrhaging, according to the findings of a new study.
Many women who suffer from depression take medications during pregnancy to prevent serious depressive episodes. However, continuing to take Cymbalta during pregnancy can lead to some serious side effects, according to Harvard researchers.
In a study published last week in the medical journal The BMJ, researchers outlined results from a cohort study nested in the Medicaid Analytic eXtract study, which included nearly 4 million women ages 18 to 55 years old and their newborn infants, from 2004 to 2013.
Researchers compared the mother’s exposure during pregnancy to Cymbalta (duloxetine), to exposure to selective serotonin reuptake inhibitors (SSRIs), exposure to Effexor (venlafaxine), and exposure to Cymbalta before pregnancy but not used during pregnancy.
According to the findings, pregnant women who took Cymbalta had a 1.5 fold increased risk of experiencing severe hemorrhaging postpartum. Postpartum hemorrhaging occurred in 23 women out of 1,000 patients. This can be especially dangerous and if not treated quickly can lead to death.
In addition, heart malformations occurred in 13.7 infants out of 1,000.
The other risks, including pre-eclampsia, preterm birth, small for gestational age, and congenital malformations were less of a problem for women taking Cymbalta.
Prior studies have shown other side effects are linked with taking Cymbalta and other antidepressants during pregnancy. One study indicated using antidepressants during pregnancy increased the risk of gestational diabetes by more than 50%.
The researchers warned that patients should not immediately stop taking their depression medications. Some patients report experiencing severe withdrawal symptoms and psychological side effects after they quit taking Cymbalta cold turkey.
Instead, patients should talk to their doctor and weigh the risks against the benefits of taking the medication during pregnancy. Often, when a patient’s depression is serious enough, taking the medication may be the best option to prevent other harms.
Patients who do want to stop taking the medication should work with their doctor to create a plan to gradually lower their dosage.
“While continuing to monitor the safety of duloxetine as data accumulate over time, these potential small increases in risk of relatively uncommon outcomes must be weighed against the benefits of treating depression and pain during pregnancy in a given patient,” the study authors wrote.