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Cymbalta & Pregnancy Side Effects

Cymbalta (duloxetine) is a selective serotonin-norepinephrine reuptake inhibitor (SNRI) which affects the levels of neurotransmitters in the brain. Doctors mainly prescribe Cymbalta to treat depression and generalized anxiety. It also is effective at treating diabetic peripheral neuropathy, a condition which causes pain or numbness in the hands or feet. Additionally, doctors prescribe Cymbalta to relieve pain associated with the muscle disorder fibromyalgia. Cymbalta is generally not recommended during pregnancy.

  1. Category C

    • The U.S. Food and Drug Administration (FDA) uses categories to identify drug safety during pregnancy. The agency has classified Cymbalta as Pregnancy Category C, the category assigned when clinical studies with pregnant animals have shown risks to the fetus. When Cymbalta was administered to pregnant rats, the babies weighed less than normal and were less likely to survive.

    Considerations

    • Doctors usually advise pregnant women to stop taking Cymbalta during pregnancy. However, if the benefits are determined to outweigh the risks, the patient may be able to continue taking Cymbalta. For instance, a woman with untreated major depression may behave in ways that are unhealthy for her unborn baby.

    PPHN Occurrence

    • A study published in the Feb. 9, 2006 issue of the New England Journal of Medicine showed that women who took selective serotonin reuptake inhibitors (SSRIs), similar to SNRIs, late in pregnancy were six times more likely to have a baby with persistent pulmonary hypertension of the newborn (PPHN). PPHN is characterized by constricted blood vessels in the lungs, so that when blood is pumped back from the lungs to other organs, it delivers inadequate oxygen. This can be life-threatening for the baby.

    More Research Needed

    • According to the Massachusetts General Hospital Center for Women's Mental Health, although duloxetine appears to have similar mechanisms of action as SSRIs, no peer-reviewed studies have focused on the use of this particular medication during pregnancy. The Center website states that some of the risks linked to other antidepressants during pregnancy likely apply to duloxetine as well and are listed in Cymbalta's package insert, but systematic research is needed.

    Withdrawal

    • Cymbalta can cause withdrawal symptoms if people stop taking it suddenly. When a woman is regularly taking Cymbalta toward the end of her pregnancy, the baby will experience withdrawal after delivery. These babies may have insomnia, be agitated, and cry continuously.

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