Key takeaways

Effexor (venlafaxine) usage during pregnancy is a concern for many, but research is mixed on whether it increases the risk of birth defects or miscarriage, with some studies suggesting similar risk levels to the general population.
There are no current studies directly linking Effexor with infertility in men or women. Untreated depression itself is associated with a higher risk of miscarriage.
Effexor may lead to toxic symptoms, withdrawal, or serotonin syndrome in newborns if taken throughout pregnancy or while breastfeeding, necessitating possible prolonged hospitalizations.
While many antidepressants are considered safe during pregnancy, Effexor is generally not the first choice. Zoloft is preferred due to its long-standing market presence and extensive research backing its safety. It’s important to consult a healthcare provider for professional medical advice regarding your condition and treatment.

When you’re pregnant, you want to do everything you can to make sure the baby is safe and healthy. At the same time, you want to keep yourself healthy, too. Many women take medications during pregnancy to treat ongoing health conditions, but how do you know if they’re safe?

According to a CDC report, the number of American adults taking antidepressants is on the rise, especially among women. Nearly 18% of women say they’ve taken an antidepressant in the past month compared to just over 8% of men.

Effexor (venlafaxine) is an antidepressant that’s part of a group of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs). It alters brain chemicals that may be unbalanced in people with depression. It’s also commonly prescribed in extended-release formulation, called Effexor XR. Besides depression, Effexor is also taken to treat anxiety and repeated panic attacks. If you’re taking Effexor and you are pregnant or planning to become pregnant, you may be wondering whether it’s safe to take Effexor, or Effexor XR, during pregnancy.

Can taking Effexor make it harder to get or stay pregnant?

There are no studies currently examining if Effexor can cause infertility in men or women or increases the time it takes to get pregnant. Most research studies have not shown a link between Effexor and a higher chance of miscarriage, but one study found that women taking Effexor were more likely to miscarry. There is an increased risk of miscarriage in women with untreated depression.

Is Effexor safe during early pregnancy?

“As a psychiatrist, I evaluate many depressed and anxious women who are pregnant and breastfeeding,” says Leela Magavi, MD, psychiatrist and regional medical director of Community Psychiatry in Southern California. “Venlafaxine or Effexor may be a safe antidepressant to target mood and anxiety symptoms during pregnancy.”

Research is mixed about whether Effexor raises the chance of birth defects or other health issues. Dr. Magavi says, in general, all pregnant women have a 3% to 5% chance of having a baby with a birth defect. Research on more than 700 women who took Effexor while pregnant shows that their risk was around the same range: 3% to 5%.

Some research shows that Effexor is safe to take during the first trimester. But, a study published in JAMA Psychiatry links taking Effexor during early pregnancy with more birth defects than other antidepressants, including defects of the:

Heart
Brain
Spine
Penis (hypospadias)
Abdominal wall (gastroschisis)
Lip and roof of the mouth (cleft lip and cleft palate)

The study’s authors acknowledge that more research is needed.

Is Effexor safe in late pregnancy and while breastfeeding?

Women who take Effexor throughout their pregnancy, including the third trimester, and while breastfeeding may have babies with toxic symptoms, withdrawal, and even serotonin syndrome, such as:

Jitteriness
Irritability
Muscle tone conditions (hypotonia or hypertonia)
Tremors
Seizures
Trouble breathing and blue skin due to lack of oxygen
Vomiting
Low blood sugar
Trouble eating and sleeping
Constant crying
Abnormal sleep patterns

These symptoms may require prolonged hospitalizations, and other measures such as tube feeding and breathing support.

Which antidepressants are safe to take while pregnant and nursing?

Pregnant women can use most antidepressants safely during pregnancy. But, Effexor is “generally not the first choice when initiating antidepressant therapy during pregnancy,” says Leslie Southard, Pharm.D., founder of The Lactation Pharmacist.

Dr. Southard and Dr. Magavi agree that Zoloft (sertraline) is preferred. It’s considered one of the safest antidepressants for pregnant women since it’s been on the market for 30 years and has the most data behind it. Though, Zoloft may also come with complications. Be sure to discuss it with your healthcare provider.

Your healthcare provider can help you decide which medication and dosage will work best based on your needs and overall physical and mental health.

Do not start or stop an antidepressant before first talking to your healthcare provider. Suddenly stopping an antidepressant may actually cause more harm than taking it. “This could potentially lead to worsening mood and anxiety symptoms, which could adversely affect both mom and baby,” Dr. Magavi says.

If you decide to stop taking your antidepressant during pregnancy, your healthcare provider will gradually decrease the dose over time. They’ll also discuss other ways to manage your mental health conditions.