SNRI during pregnancy | SNRI

SNRI during pregnancy

Pregnancy and antidepressants are two closely interwoven topics, as numerous studies have shown that the incidence of depression is significantly higher among pregnant women and women in the puerperium than in the general population. The most important piece of advice regarding pregnancy during depression treatment is to tell your doctor that you are pregnant or planning to become pregnant. Many antidepressants are unsuitable for pregnant women, and serotonin noradrenaline reuptake inhibitors in particular should be used with extreme caution in pregnant women.Especially in the late phase of pregnancy, SNRI can cause a variety of symptoms in the child that appear after birth.

These include sleep and breathing disorders, seizures or increased blood pressure. For this reason, a pregnant woman with depression should first exhaust all possibilities of non-drug treatment. First and foremost, psychotherapy should be mentioned here, since even herbal remedies such as St. John’s wort are not considered completely unproblematic during pregnancy.

However, the patient should never interrupt an ongoing drug therapy by herself when pregnancy occurs! As already indicated above, in this case a doctor should be informed immediately, who can then make a well-founded decision on the further treatment of depression during pregnancy, taking all aspects into account. However, if the pregnant patient is suffering from very severe depression which cannot be controlled without drug treatment, selective serotonin reuptake inhibitors (SSRI) such as citalopram or an active substance from the group of tricyclic antidepressants should be used rather than serotonin noradrenalin reuptake inhibitors.

Although these are also not without risk to the child, they have been much better investigated with regard to their potential for damage during pregnancy than the less frequently used SNRIs and, at moderate doses, carry a relatively manageable risk of damage to the child. The use of serotonin noradrenaline reuptake inhibitors also poses a problem during lactation. This is because the active substance can pass into breast milk and thus, when transferred to the child during breastfeeding, can lead to similar symptoms as when transferred during pregnancy (see above).

In this respect, the patient and the physician should jointly weigh up the options between breastfeeding and abstaining from antidepressants on the one hand, or feeding industrial baby food and using antidepressants on the other. In order to make a decision, it should be ascertained how pronounced the depression is in the mother and how well it can be controlled with non-drug measures (psychotherapy, natural remedies) and, in contrast, how important breastfeeding is to the mother. However, recent studies suggest that low doses of serotonin noradrenaline reuptake inhibitors do not pose a risk to the child through breastfeeding.