Duloxetine during Pregnancy

Pregnancy and the increase in hormones often trigger depression or worsen it for someone already experiencing it. It is the most frequently diagnosed mental condition resulting in the majority of prescription medications. Duloxetine, or more frequently called Cymbalta, is a medication used to treat both depression and anxiety.

Duloxetine, or Cymbalta, use during pregnancy and the safety for the baby is a common question. Since depression is diagnosed more commonly in women and pregnancy triggers or worsens depression, it is no wonder that concern for the health and wellness of the baby comes to mind.

Depression is challenging for anyone to manage and it often interferes with healthy practices like eating well balanced meals and exercising. Both of these are important for both you and your baby. So, if you are dealing with depression, it is important to talk to your health care provider about options for managing your care.

Brand name: CymbaltaManufacturer: Eli Lilly

Therapeutic Effect:

Cymbalta is indicated for:

  • The treatment of major depressive disorder.
  • The treatment of generalized anxiety disorder. Generalized Anxiety Disorder is defined by the DSM-IV as excessive anxiety and worry, present more days than not, for at least 6 months.
  • The management of neuropathic pain associated with diabetic peripheral neuropathy.
  • The management of fibromyalgia.

Pregnancy Safety Rating: Category: C

Pregnancy Recommendation: Human data suggest risk in 3rd trimester

Duloxetine Side Effects:

  • Frequent (20%-11%): Nausea, dry mouth, constipation, insomnia.
  • Occasional (9%-5%): Dizziness, fatigue, diarrhea, drowsiness, anorexia, diaphoresis, vomiting.
  • Rare (4%-2%): Blurred vision, erectile dysfunction, delayed or failed ejaculation, anorgasmia, anxiety, decreased libido, hot flashes.

Lifespan Considerations

May produce neonatal adverse reactions (constant crying, feeding difficulty, hyperreflexia, irritability). Unknown if distributed in breast milk. Breast-feeding not recommended.

Pregnancy Summaries

Briggs, Freeman, & Yaffe – Duloxetine causes developmental toxicity in animals (growth restriction in rats and rabbits; behavior deficits and death in rats) at doses

Sources:

  1. Hudgson, Barbara and Kizior, Robert, Saunders Nursing Drug Handbook 2012, Elsevier, St. Louis, MO. ISBN: 978-1-4377-2334-2.
  2. Briggs, Gerald, Freeman, Roger and Yaffe, Sumner, Drugs in Pregnancy and Lactation, 9th Ed., Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, PA. ISBN: 978-1-60831-708-0, 2011.
  3. Physicians’ Desk Reference (PDR), PDR Network, LLC, Motvale, NJ 07645 ISBN: 978-1-56363-780-3
  4. Reproductive Toxicology Center, http://www.reprotox.org, agent # 3983