Desyrel® (trazodone) and Serzone® (nefazodone)
Organization of Teratology Information Specialists, 2004 See article at otispregnancy.org
[len:7686, cleaned:] D:\wwwroot\tripdatabaseplus_live\control\reindex\html\1496DFA5-A8E7-47C9-9B78D1E9EC294193 For more information about the Organization of Teratology Information Specialists or to find a service in your area, call (866) 626-6847 or visit us online at: www.OTISpregnancy.org. Desyrel_ (trazodone) and Serzone_ (nefazodone) and pregnancy Any woman who gets pregnant has a 3 - 5% chance of having a baby with a birth defect. The information below will help you to determine if your exposure to trazodone/ nefazodone during pregnancy increases your risk above this background risk. This information should not be used as a substitute for the medical care and advice of your health care provider. What is trazodone and nefazodone? Can taking trazodone/nefazodone make it more difficult for me to become pregnant? Trazodone and nefazodone are antidepressants which are almost exactly the Currently, there are no reports that same except nefazodone is much newer. link these drugs with an inability to become They are unrelated to other classes of pregnant. antidepressants. Trazodone and nefazodone are also used to treat the symptoms of I have heard that trazodone/ nefazodone insomnia, tremors, anxiety disorders, and can cause a miscarriage. Is this true? some pain syndromes. Trazodone is the generic name for Desyrel and nefazodone is There has been one study that the generic name for Serzone. compared the rates of miscarriage while taking trazodone/nefazodone. Even though I am taking trazodone/nefazodone, but I there were more miscarriages in the would like to stop taking it before becoming trazodone/nefazodone group they were still pregnant. How long does the drug stay in within the baseline of expected rates of my body? miscarriages.. While everyone breaks down Can taking trazodone/nefazodone during medication at a different rate, it may take my pregnancy cause birth defects? approximately 5 days for either drug to be eliminated from the body once it is stopped. One study followed 147 women who took trazodone or nefazodone while I take trazodone/nefazodone and I am pregnant. All of these women took the already pregnant. Should I stop taking it? medication in the first trimester of pregnancy and more than a third of patients You should not stop taking any took the medication throughout the entire medication without first talking with your pregnancy. There were 58 women were doctor. If you do decide to stop after exposed to trazodone and 89 exposed to discussing it with your doctor, you should nefazodone. There was no increase in birth gradually decrease the dose. These drugs defects above the normal 3-5% risk for the should never be abruptly discontinued. general population. While this study is reassuring, the numbers are not large enough to completely rule out a risk. Will taking trazodone/nefazodone have any effect on my baby's behavior and July 2003. development? Copyright by OTIS. Reproduced by permission. There are no studies on the behavior or development of infants exposed to these drugs during pregnancy. Long-term studies are needed in order to determine if there are any adverse effects on the baby's behavior References and development. Barcellona PS (1970) "Investigations on the I need to take trazodone/ nefazodone possible teratogenic effects of trazodone in throughout my entire pregnancy. Will it rats and rabbits." Boll Chim Farm 109:323- cause withdrawal symptoms in my baby? 332. There have not been any case reports Einarson A, et al. (2003) "A multicentre or cases documented in the study that was prospective controlled study to determine carried out, that showed a link between these the safety of trazodone and nefazodone use drugs and withdrawal symptoms in the during pregnancy. Can J Psychiatry infants. However, all babies who have been 48(2):106-10. exposed during pregnancy to antidepressant drugs should be observed carefully after Froberg KM, Brown RE, Maylock J, Poling birth for any signs of withdrawal from the E (1994) "In utero development of a drug. mediastinal teratoma: A second-trimester event." Perat Diag 14:884-887. Can I take trazodone/ nefazodone while breastfeeding? Hale T (2000) Medications and Mother's Milk , 9th ed. Pharmasoft Publishing. Very small amounts of trazodone have been found in breast milk of women Rivett KF, Barcelona PS (1974) taking the drug. About 0.6% of trazodone "Toxicology of trazodone ." Mod Probl passes into the breast milk and is ingested by Pharmacopsychiatry 9:76-86. the infant. There are no case reports that have documented adverse effects from Rosa F (1994) "Medicaid antidepressant trazodone exposure via breastfeeding. There pregnancy exposure outcomes." Reprod was one case report of a premature baby, Toxic 8:444-445. where it was suggested that nefazodone affected the baby adversely through Verbeeck RK, Ross SG, McKenna EA. breastmilk, however the amount excreted in (1986) "Excretion of trazodone in breast the milk was even less than trazodone milk." Br J Clin Pharmacol. 22(3):367-70. (0.45%) and it was felt that these adverse effects were because the baby was Yapp P, et al. Drowsiness and poor feeding premature. in a breast-fed infant: association with nefazodone and its metabolites. Ann Pharmacother 2000 Nov;34(11):1269-72
