Can You Take Remeron While Pregnant?
Remeron’s active ingredient is something called mirtazapine. Remeron is a brand-name drug, classified as an atypical antidepressant. Along with properties of an antidepressant, Remeron is a sedative, and it has appetite stimulating effects. It can be used for the treatment of anxiety disorders, nausea and vomiting, and insomnia. It can also help with weight gain. Remeron is believed to act on certain serotonin receptors, and it’s also an antihistamine. The specific classification of Remeron is a tetracyclic antidepressant. A recently released review showed mirtazapine to be one of the most effective and well-tolerated antidepressants available. While Remeron is primarily prescribed to treat major depressive disorder and mood disorders, there are a variety of other off-label prescribed uses for it. For example, Remeron may be prescribed to treat social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder and panic disorder.
The primary side effects of Remeron are weight gain and sleepiness. It’s less likely to cause side effects such as sexual dysfunction and nausea, which are common with SSRIs. Also common with the use of Remeron are constipation, dry mouth and weight gain. Remeron may dangerously interact with certain other drugs including MAOIs. If Remeron is combined with other drugs that increase serotonin levels in the brain, it can cause serotonin syndrome. So, what about pregnancy? Can you take Remeron while pregnant? Remeron’s active ingredient, mirtazapine, is a category C drug. The U.S. Food and Drug Administration created categories that indicate how safe or potentially harmful substances are during pregnancy. The categories are based on the evidence currently available, including human and animal studies. Category C drugs can be a challenge for medical professionals because they have to make an individual determination as to whether they should be used. A category C drug doesn’t have enough evidence to rule out possible risks to the fetus, and there are in some cases animal studies showing possible harm to a fetus. With category C drugs like Remeron, doctors will weigh the risks compared to the benefits of the drug and decide whether a pregnant woman should continue using it.
How Does Remeron Affect a Fetus?
Conducting controlled medical studies on pregnant humans isn’t something that often happens because of the risks and the ethical concerns. Instead, most pregnancy-related studies are either based on animal studies or are observational. In an observational study, a pregnant woman can report that she used something like Remeron, and then the effects may be looked at, but there aren’t controls. Without controls, researchers aren’t entirely sure why certain results happened, although they can theorize. As of right now, with studies and case studies having looked at almost 1,000 pregnancies involving the use of mirtazapine, there hasn’t been a demonstrated link with an increased risk of birth defects. There is a small possible link between mirtazapine and the chance for miscarriage and preterm birth. Even so, researchers believe this link may actually be attributed to the depression, rather than the medicine used to treat it. There aren’t currently any studies looking at the long-term effects of mirtazapine on a baby’s behavior and development.
There are other considerations regarding the possible effects of Remeron on a fetus. First, if a woman is already taking Remeron and becomes pregnant, she shouldn’t stop using the medicine suddenly. Stopping an antidepressant suddenly can cause discontinuation symptoms. Withdrawal from an antidepressant can be harmful to a mother and an unborn baby. Untreated depression during pregnancy can be harmful as well, so this is something a healthcare provider will weigh before making a medical recommendation. Untreated depression is linked to an increased risk of premature birth and having a low birthweight baby. There is also some research that links depression during pregnancy to a baby that’s more irritable and less active.
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As with most antidepressants, if a baby is exposed to Remeron in the womb, they may develop a dependence. When this happens, the baby will likely have symptoms of withdrawal following delivery. This is called neonatal abstinence syndrome. The closer to delivery Remeron is used, the more likely this scenario is. Some of the symptoms linked to fetal exposure to Remeron include feeding and respiratory problems, muscle stiffness and continual crying. Also possible is jitteriness and seizures. If a baby is born experiencing symptoms of Remeron withdrawal, they may need special care in the NICU until the symptoms start to subside.
The decision as to whether or not Remeron should be continued during pregnancy is one that’s up to a woman and her healthcare provider. Remeron should only be used when it’s definitively needed during pregnancy. A doctor may recommend that a woman with mild depression symptoms not take medication during pregnancy, to reduce any possible risks of exposure. There may be ways to manage milder depression symptoms outside of medicine. For example, talk therapy like cognitive-behavioral therapy might be an alternative to Remeron. Regardless of your situation, don’t stop taking Remeron without first talking to your prenatal health care provider.
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