Fluoxetine is a member of antidepressants, to be more precise a member of selective serotonin reuptake inhibitors (SSRI). Even though the drug can efficiency bring all the symptoms of depression under control, it is strictly forbidden in pregnant women during the last 3 months of pregnancy. So, any pregnant woman who has been taking fluoxetine for some time, must contact her health care provider and discuss further treatment options and be informed about benefits and risks of using the drug during pregnancy and later, after giving birth to a child, during breastfeeding period.
Fluoxetine and Pregnancy
It is confirmed that babies of women who used fluoxetine or some other member of SSRIs or SNRIs in the last three months of their pregnancies were immediately hospitalized after birth and required respiratory support along with tube feeding. Around 30% of neonates developed neonatal abstinence syndrome because of the drug. They experienced tremor, gastrointestinal and sleep disturbances and hypertonicity. High-pitched cry occurred as well. Because of all the mentioned all babies born to such women are supposed to be closely monitored 48 hours after birth.
Furthermore, according to data obtained from a retrospective case-controlled study, babies of 20 weeks of gestation age or older exposed to fluoxetine have six times greater risk of ending up with pulmonary hypertension comparing to babies who are not exposed to the drug. Also such babies are at higher risk to develop three or even more minor anomalies, they are prone to structural abnormalities and their mothers are also at higher risk of spontaneous pregnancy loss.
It is also confirmed that such infants are mostly premature, frequently admitted to special care nurseries and show poor neonatal adaptation. They are prone to cyanosis associated with breathing difficulty and problems with feeding. Jitteriness occurs as well.
Several more studies have confirmed damage fluoxetine causes to the unborn baby. This is the reason why the drug is classified as pregnancy category C medication. The drug is only prescribed if benefits outweigh potential risks and if there is no other drug that can control the illness the mother is suffering from.
Fluoxetine and Breastfeeding
Because fluoxetine is excreted in small amounts in breast milk, it is unknown whether the drug may cause some adverse effects on the child. Doctors still express concern regarding breastfeeding and therapy with fluoxetine. According to data obtained from several reports, in women who breastfed their children and took different doses of fluoxetine, the drug did not occur in large concentrations in breast milk and not a single one adverse effect was reported in any of these babies.