Cymbalta is an antidepressant medication classified as an SNRI (serotonin-norepinephrine reuptake inhibitor), which means it increases levels of both serotonin and norepinephrine. Cymbalta is a Class C drug for use in pregnancy, which means that testing in animals established risks to taking the medicine, but that human studies have not been done. Specific testing on Cymbalta in pregnant women has not been done, so definite side effects have not been established. Testing on serotonin reuptake inhibitors (SSRIs), which would include Cymbalta, has revealed side effects in pregnancy.
Intrauterine Side Effects
Animal studies on rabbits and rats given Cymbalta in pregnancy showed that in both cases, the babies born had lower than normal birthweights. According to eMedTV, baby rats were also less likely to survive after intrauterine exposure to Cymbalta. Babies born to women taking SSRIs in general are reported in one 2006 study reported by the University of Ottawa to be associated with low birthweight, preterm delivery and unexplained fetal death. These problems occurred in pregnancies where SSRIs were taken in the last half of pregnancy.
Withdrawal Symptoms
A 2006 study reported in the Archives of Pediatric Adolescent Medicine found that as many as 33 percent of babies born after SSRI exposure in the second half of pregnancy had withdrawal symptoms, including jitteriness, tremors, high pitched cry, increased muscle tension and feeding and sleeping difficulties. Seizures and transient respiratory distress have also been reported.
Persistent Pulmonary Hypertension
PPH is a serious neonatal problem caused by the failure of the ductus arteriosus to close. The ductus allows blood to bypass the lungs before birth, since babies in the womb don't need to breathe to receive oxygen. At the time of delivery, the ductus closes so that blood can flow to the lungs for oxygenation. Babies with PPH are said to have persistent fetal circulation, or PFC. PFC is fatal to a newborn 10 to 20 percent of the time. A study reported by Christina Cambers, M.D. et al in the "New England Journal of Medicine" in 2006 found that SSRI exposure in the last 20 weeks of pregnancy increased the risk of PPH sixfold. These studies were not specific to Cymbalta, but looked at women on SSRI medications overall.
References
- eMedTV: Cymbalta and Pregnancy
- Massachusetts General Hospital: What Would You Do? A Pregnant woman on Duloxetine
- Healthline: More on Meds and Pregnancy: Adderall and Cymbalta; Kenneth Trotter, MD
- Healthline: SSRIs and Persistent Pulmonary Hypertension; Kenneth Trotter, MD
- New England Journal of Medicine: Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn; Christina Chambers, M.D. 2006
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