This Antidepressant Linked to Postpartum Bleeding
Other depression drugs known as SSRIs did not show risk, researchers say
By Dennis Thompson
FRIDAY, Feb. 12, 2016 (HealthDay News) -- The antidepressant Effexor (venlafaxine) appears to increase a pregnant woman's risk of excess bleeding following labor, researchers say.
Effexor, a serotonin-norepinephrine reuptake inhibitor (SNRI), was linked with a more than 70 percent increased risk of postpartum hemorrhage in a study of more than 300,000 Canadian pregnancies.
The researchers also found that selective serotonin reuptake inhibitors (SSRIs) -- a much more commonly used class of antidepressant that includes citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) -- posed no increased risk for postpartum hemorrhage.
The study findings were published in a report in the March issue of Obstetrics & Gynecology
Excessive bleeding after labor accounts for nearly one-quarter of all pregnancy-related deaths worldwide, according to the U.S. Agency for Healthcare Research and Quality (AHRQ).
In North America, these deaths are rare but bleeding still remains a risk for some new mothers, said study lead author Gillian Hanley, an assistant professor with the University of British Columbia's department of obstetrics and gynecology.
"A severe hemorrhage could result in an emergency operation to stop the bleeding, and often may result in blood transfusions," Hanley said. Complications can include shock, organ failure, infection and dangerous blood clots, according to the AHRQ.
About 5 percent of American and Canadian women use antidepressants at some point during their pregnancy, according to background information with the study, and there has been some concern that these medications increase bleeding risk for mothers.
To investigate this, researchers tracked over 322,000 pregnancies in British Columbia between 2002 and 2011. The focus was primarily on women who used antidepressants in the last 30 days of their pregnancy (late pregnancy), and women who used antidepressants in the last five months of pregnancy but not the last 30 days (mid-pregnancy).
About 6,600 women in the group were taking an SSRI during mid- or late pregnancy, while almost 1,400 women were taking an SNRI, the study reports. Of the women taking an SNRI, 98 percent were taking Effexor.
Researchers found no effect on bleeding risk from either SSRIs or SNRIs taken mid-pregnancy. They also found that SSRIs used in late pregnancy did not increase bleeding risk.