Trazodone

(Date: March 2018. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

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What is it?

Trazodone (Molipaxin®) is a medicine that acts on the brain and nerves and is used to treat anxiety and depression.

Is it safe to take trazodone in pregnancy?

This leaflet summarises the scientific studies relating to the effects of trazodone on a baby in the womb. When considering treatment with trazodone in pregnancy it is necessary for women and prescribers to weigh up the risks and benefits to both mother and baby of using a medication against those of not taking it. The outcome of this assessment will vary from person to person and will depend on the severity of the mother’s condition and the complications that could arise if her treatment is altered. Some of the possible risks to a baby may depend on how many weeks pregnant you are. Remaining well is particularly important during pregnancy and while caring for a baby. For some women, treatment with trazodone during pregnancy may be considered necessary.

What if I have already taken trazodone during pregnancy?

If you have taken any medicines, it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and to make sure that you are taking the lowest dose that works.

It is very important that you do not suddenly stop taking trazodone as this could be dangerous to you, and to your baby if you are already pregnant. Do not make any change to your medication without first talking to your doctor.

Can taking trazodone in pregnancy cause birth defects in my baby?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

Around 180 women who took trazodone during early pregnancy have been studied. These women did not have a higher chance of having a baby with a birth defect than women who didn’t take trazodone. However, a much larger number of pregnancies need to be studied before we can say for sure whether or not taking trazodone in pregnancy increases the chance of birth defects in the baby.

Can taking trazodone in pregnancy cause miscarriage, stillbirth, or low birth weight in the baby?

No increased chance of miscarriage, stillbirth, or of having a low birth weight baby was seen in women who had taken trazodone or a related medicine during pregnancy in the one study which investigated these problems. However, because only small numbers of pregnant women taking trazodone have been studied and most of these women took trazodone in the early stages of pregnancy only, more information needs to be collected.

Can taking trazodone in pregnancy cause preterm birth?

No studies have specifically assessed the chance of preterm birth (before 37 weeks) in women taking trazodone in pregnancy. The timing of delivery was investigated in around 200 pregnant women taking trazodone or a related medicine, with no evidence that exposure to these medicines affects the length of pregnancy. However, in the first of these studies only a small number of the women carried on taking trazodone or a related medicine after the first trimester. Because only small numbers of women have been studied, particularly those who took trazodone later in pregnancy, more research is required.

Can taking trazodone in pregnancy cause other health problems in the child?

Withdrawal symptoms at birth (‘neonatal withdrawal’)
Withdrawal symptoms are thought to occur as the newborn baby’s body has to adapt to no longer getting certain types of medicines through the placenta.

No scientific studies have examined whether trazodone use in pregnancy may cause withdrawal problems in the baby after birth. However, studies have shown that other medicines that are similar to trazodone may cause neonatal withdrawal. Close monitoring of your baby for a few days after birth may therefore be advised if you have taken trazodone regularly in the weeks before delivery.

Learning and behavioural problems
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

No scientific studies that have investigated any possible links between taking trazodone in pregnancy and learning or behavioural problems in the child later on in life.

Will my baby need extra monitoring?

Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine antenatal care. Taking trazodone in pregnancy would not normally require extra monitoring of your baby before birth.

If you have taken trazodone around the time of delivery your baby may require extra monitoring after birth because of the possible risk of neonatal withdrawal.

Are there any risks to my baby if the father has taken trazodone?

We would not expect any increased risk to your baby if the father took trazodone before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

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WE NEED YOUR HELP! Do you have 3 minutes to complete a short, quick and simple 12 question user feedback form about our bumps information leaflets? To have your say on how we can improve our website and the information we provide please visit www.surveymonkey.co.uk/r/uktis-bumps.

General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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