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Q: MATERNITY IMPACT FROM PRESCRIPTION DRUGS ( Answered,   1 Comment )
Question  
Subject: MATERNITY IMPACT FROM PRESCRIPTION DRUGS
Category: Health > Medicine
Asked by: bchung1974-ga
List Price: $200.00
Posted: 17 Apr 2006 03:22 PDT
Expires: 17 May 2006 03:22 PDT
Question ID: 719721
I have been taking ambien, 10 meg, 12.5 CR tablets. I also reguluarly
take Sominex sleeping pills. And i have been doing this for the pas 2
year. I'm also on a couple metdications too .. lexapro, and wellbutrin
continual release. MY QUESTION IS...WILL MY PHARMACY PRECIPTIONS
CREATE COMPLICATIONS WITH MY FIRST NEWBORN CHILD?
Answer  
Subject: Re: MATERNITY IMPACT FROM PRESCRIPTION DRUGS
Answered By: politicalguru-ga on 17 Apr 2006 05:04 PDT
 
Dear Bchung, 

First of all, I refer you to the disclaimer at the bottom of this
page: "Answers and comments provided on Google Answers are general
information, and are not intended to substitute for informed
professional medical, psychiatric, psychological, tax, legal,
investment, accounting, or other professional advice"
.  If you feel that you need to consult a physician, don't see the
advice here as a substitute.

The general advice regarding taking drugs during the pregnancy and
later, during  breastfeeding, is to avoid taking drugs, unless the
benefit of the drug is greater than the possible risk to the baby (or
to you health).

Only you, and a psychiatrist who knows you, can determine if your
depression is so bad that not taking these drugs might have an adverse
reaction that would risk you and the baby. In some cases, for example,
it is possible to take the drug for only part of the period - when it
is less harmful; or to avoid breastfeeding (although it is very good
for your health, not to mention the baby's) - so you can take those
drugs.

Let's start with the sleep medications, since you began with them.
However, the more important information refers to the
anti-depressants.

Ambien is not recommended during the pregnancy and the nursing period: 
"Pregnancy Category B

Teratogenic Effects: Studies to assess the effects of zolpidem on
human reproduction and development have not been conducted.

Teratology studies were conducted in rats and rabbits.

In rats, adverse maternal and fetal effects occurred at 20 and 100 mg
base/kg and included dose-related maternal lethargy and ataxia and a
dose-related trend to incomplete ossification of fetal skull bones.
Under-ossification of various fetal bone indicated a delay in
maturation and is often seen in rats treated with sedative/hypnotic
drugs. There were no teratogenic effects after zolpidem
administration. The no-effect dose for maternal or fetal toxicity was
4 mg base/kg or 5 times the maximum human dose on a mg/m2 basis.

In rabbits, dose-related maternal sedation and decreased weight gain
occurred at all doses tested. At the high dose, 16 mg base/kg, there
was an increase in postimplantation fetal loss and underossification
of sternebrae in viable fetuses. These fetal findings in rabbits are
often secondary to reductions in maternal weight gain. There were no
frank teratogenic effects. The no-effect dose for fetal toxicity was 4
mg base/kg or 7 times the maximum human dose on a mg/m2 basis.

Because animal reproduction studies are not always predictive of human
response, this drug should be used during pregnancy only if clearly
needed.

Nonteratogenic Effects: Studies to assess the effects on children
whose mother took zolpidem during pregnancy have not been conducted.
However, children born of mothers taking sedative/hypnotic drugs may
be at some risk for withdrawal symptoms from the drug during the
postnatal period. In addition, neonatal flaccidity has been reported
in infants born of mothers who received sedative/hypnotic drugs during
pregnancy.

Labor and Delivery

Zolpidem tartrate has no established use in labor and delivery.

Nursing Mothers

Studies in lactating mothers indicate that the half-life of zolpidem
is similar to that in young normal volunteers (2.6 ± 0.3 hr). Between
0.004 and 0.019% of the total administered dose is excreted into milk,
but the effect of zolpidem on the infant is unknown.

In addition, in a rat study, zolpidem inhibited the secretion of milk.
The no-effect dose was 4 mg base/kg or 6 times the recommended human
dose in mg/m2.

The use of zolpidem tartrate in nursing mothers is not recommended." 
(SOURCE: RX List, <http://www.rxlist.com/cgi/generic/zolpid_wcp.htm>). 

Sominex is generally considered safe during pregnancy (but not during
breastfeeding), though - as mentioned before - I suggest that you'll
discuss it with your doctor before taking it during the pregnancy.

Recommended reading: 
Jodi Mindell, Ph.D., "Sleep aids during pregnancy",
<http://www.babycenter.com/refcap/pregnancy/pregnancysleep/7914.html>

Here are advices for natural stuff that might help you get to sleep: 
Priscilla C. Bone, "Dreaming The Night Away", Pioneer Thinking
<http://www.pioneerthinking.com/naturalsleep.html> 

Sleep Aids
<http://www.stanford.edu/~dement/sleepaids.html> 

Helping Yourself to a Good Night's Sleep
<http://www.sleepfoundation.org/sleeplibrary/index.php?secid=&id=55> 

Regarding the anti-depressants, I would recommend - if possible -
taking Prozac or Zoloft instead of Lexapro. There hasn't been enough
research done on the possible effect of Lexapro on the fetus and
later, on the breastfeeding baby:
"Currently there are no adequate and well-controlled studies of
LEXAPRO in pregnant women; therefore, LEXAPRO (escitalopram) should be
used during pregnancy only if the potential benefit to the woman
justifies the potential risk to the fetus. All SSRIs are generally
considered to be safe in animals except at very high doses, but the
FDA warns that although there appear to be no general problems, it
cannot be said with certainty that difficulties might not arise in
pregnancy.

There are several studies that show that untreated depression during
pregnancy is more likely to result in pregnancy problems. Taking
LEXAPRO (or any antidepressant) during pregnancy is an example of the
necessity for careful and informed discussion between a woman and her
physician with the resulting decision being one in which risks vs
benefits of medication (or no treatment at all) be carefully and fully
evaluated.

As for breastfeeding, LEXAPRO, like many other drugs, is excreted in
human breast milk. Side effects from LEXAPRO in a nursing baby are
generally rare.  If they do occur, side effects may include
sleepiness, decreased feeding, and potential weight loss. Again, this
is something a woman should discuss in detail with her physician."
(SOURCE: LEXAPRO® FAQS: For Women Taking Lexapro,
<http://www.healthyplace.com/lexapro/faqs_6.asp>).

See also: 
"Escitalopram is metabolized to S-DCT and S-didemethylcitalopram
(S-DDCT). In humans, unchanged escitalopram is the predominant
compound in plasma. At steady state, the concentration of the
escitalopram metabolite S-DCT in plasma is approximately one-third
that of escitalopram."

Oral administration of escitalopram to pregnant rats during the period
of organogenesis resulted in decreased fetal body weight and
associated delays in ossification at approximately >/=56 times the
maximum recommended human dose [MRHD]* of 20 mg/day. The developmental
no effect dose of 56 mg/kg/day is approximately 28 times the MRHD*. No
teratogenicity was observed at any of the doses tested (as high as 75
times the MRHD*).

When female rats were treated with escitalopram during pregnancy and
through weaning, slightly increased offspring mortality and growth
retardation were noted at approximately 24 times the MRHD*. The no
effect dose was 12 mg/kg/day which is approximately 6 times the MRHD*.

We were unable to locate reports describing the use of escitalopram
during human pregnancy.

BREAST FEEDING: No reports were located describing the use of
escitalopram during human lactation. However, racemic citalopram is
excreted into human breast milk. The manufacturer recommends the
decision whether to continue or discontinue either nursing or LEXAPRO
therapy should take into account the risks of exposure for the infant
and the benefits of LEXAPRO treatment for the mother."
(SOURCE: Escitalopram (Lexapro TM) ,
<http://www.perinatology.com/exposures/Drugs/Escitalopram.htm>).

Wellburtin is considered less harmful to the fetus and the breastfed
baby. Its description:
"Wellbutrin is in the FDA pregnancy category B. This means that it is
unlikely to harm an unborn baby. Do not take Wellbutrin without first
talking to your doctor if you are pregnant.
	? 	It is not known whether Wellbutrin will harm a nursing baby. Do
not take Wellbutrin without first talking to your doctor if you are
breast-feeding a baby." (SOURCE: drugs.com ,
<http://www.drugs.com/wellbutrin.html>).

Pregnancy is an emotional time in any case, because of the hormone
changes (and naturally, also because of the drastic change in life
afterwards). Women who are not normally on anti-depressants might
experience severe mood changes; many women experience insomnia to a
certain extent. This is not said in order to scare you - you are
pregnant (or planning to be) - all the power to you!

This means, that it would be best to discuss the pregnancy and its
implications with your doctor.

I hope this answers your questions. Please contact me if you need any
clarifications on this answer before you rate it. My search terms
were:
sominex pregnancy, sleep aids, ambien breastfeeding, lexapro
breastfeeding, ambien pregnancy, ambien

I wish you a happy, easy and fun (yes, it could be fun) pregnancy, and
if I may, I strongly recommend "The Pregnancy Book" (by Martha and Dr.
William Sears).

Request for Answer Clarification by bchung1974-ga on 17 Apr 2006 16:42 PDT
Thanks so much for the clarification.

I should have been more explicit in the question -- I'm posing the
question as a father instead of a mother.

Clarification of Answer by politicalguru-ga on 18 Apr 2006 00:21 PDT
Are you asking whether the drugs might affect the baby through your sperm?

Request for Answer Clarification by bchung1974-ga on 18 Apr 2006 23:27 PDT
Clarification of Answer by politicalguru-ga on 18 Apr 2006 00:21 PDT
Are you asking whether the drugs might affect the baby through your sperm?

Thanks for the question politicalguru-ga. I am worried about whether
the drugs could affect the baby through my sperm.

Clarification of Answer by politicalguru-ga on 19 Apr 2006 00:36 PDT
Dear Bchung, 

I am pleased to say that the answer is negative. There are no
evidences that a fetus is affected through the sperm. There are some
claims, however, that anti-depressants adversely affect fertility
(that is, that you might have more problems to conceive than couples
who do not take anti-depressants).

Lots of success with the child (that book is still recommended...).
Comments  
Subject: Re: MATERNITY IMPACT FROM PRESCRIPTION DRUGS
From: frde-ga on 17 Apr 2006 06:41 PDT
 
I had a look earlier, but Polly had the question locked when I posted.
Mainly because I was curious what the drugs are used for.

More follows :-

http://www.drugs.com/ambien.html

|?  Ambien is in the FDA pregnancy category B. This means that it is
unlikely to harm an unborn baby. Do not take Ambien without first
talking to your doctor if you are pregnant or could become pregnant
during treatment.
 ?  Ambien passes into breast milk and may affect a nursing baby. Do
not take this medication without first talking to your doctor if you
are breast-feeding a baby|

http://www.drugs.com/mtm/s/sominex.html

|?  Diphenhydramine is in the FDA pregnancy category B. This means
that it is not expected to be harmful to an unborn baby. Do not take
diphenhydramine without first talking to your doctor if you are
pregnant.
 ?  Infants are especially sensitive to the effects of antihistamines,
and side effects could occur in a breast-feeding baby. Do not take
diphenhydramine without first talking to your doctor if you are
nursing a baby. |

http://www.drugs.com/mtm/l/lexapro.html

|?  Escitalopram is in the FDA pregnancy category C. This means that
it is not known whether escitalopram it will be harmful to an unborn
baby. Do not take escitalopram without first talking to your doctor if
you are pregnant or could become pregnant during treatment.
 ?  Escitalopram passes into breast milk and may affect a nursing
infant. Do not take escitalopram without first talking to your doctor
if you are breast-feeding a baby.|

http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/lex1642.shtml

|Special information if you are pregnant or breastfeeding

There have been reports of newborns developing serious complications
after exposure to Lexapro late in the last 3 months of pregnancy. If
you are pregnant or plan to become pregnant, inform your doctor
immediately. Lexapro should be taken during pregnancy only if its
benefits outweigh the potential risks.

Lexapro appears in breast milk and can affect a nursing infant. If you
decide to breastfeed, Lexapro is not recommended.|


http://www.drugs.com/mtm/w/wellbutrin.html

|?  Bupropion is in the FDA pregnancy category B. This means that it
is not expected to be harmful to an unborn baby. Do not take bupropion
without first talking to your doctor if you are pregnant or could
become pregnant during treatment.
 ?  It is not known whether bupropion will be harmful to a nursing
baby. Do not take bupropion without first talking to your doctor if
you are breast-feeding a baby.|

http://www.healthsquare.com/newrx/WEL1488.HTM

|If you are pregnant or plan to become pregnant, notify your doctor
immediately. Wellbutrin should be taken during pregnancy only if
clearly needed.

Wellbutrin does pass into breast milk and may cause serious reactions
in a nursing baby; therefore, if you are a new mother, you may need to
discontinue breastfeeding while you are taking this medication.|

----------------------------------------------------

The general pattern is that they are not certain that the drugs are harmful
- and the 'consult your doctor' stuff might sound a bit formulaic, but
it makes a lot of sense.

I've only collected the most relevant bits, but I was alarmed by other
stuff such as the effects of sudden withdrawel.

From looking at PoliticalGuru-GA's research, it appears that a measure
of 'effect' is ossification
- which means bone development - and is fairly easy to observe
- the other thing that is easy to measure is 'maturation' which just
means growth or development.

|In addition, neonatal flaccidity has been reported in infants born of
mothers who received sedative/hypnotic drugs during pregnancy.|
- is jargon for the child was born stoned.

My guess is that you have problems sleeping, are diagnosed as
'depressed' and have an allergy - probably hay fever.

I have no qualifications - apart from a deep distrust of some doctors,
but I think that you should consult another doctor, preferably one
unconnected with friends or family
- preferably a female from a different background or environment.

If you don't like something - change it.

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