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Is Surmontil intake safe during pregnancy?

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Posted on Mon, 19 May 2014
Question: I need to know if surmontil is ok to take while pregnant I have been taking it for 20 yrs I've tried to come off it a a number of times but have been mentally and physically sick. I will be 7 weeks pregnant this week. My GP says it ok but another doctor I saw yesterday said to come off it right away and to go cold XXXXXXX I explained in the past when I have tried to come off it I haven't slept for 6 days and she seems to think that's ok, I also get a suppressed appetite, cannot function or cope with anxiety and depression which is why I was put on it in the first place. I'm worried and anxious that feeling this way is not ok for my baby.. I didn't take it last night and I haven't slept at all.
doctor
Answered by Dr. Saul Weinreb (1 hour later)
Brief Answer:
Stopping is good

Detailed Answer:
Hi,

Thanks for your query.

Surmontil is a pregnancy class C drug, which means that there are no studies in humans that either prove it is safe or prove that it is harmful in pregnancy. However, animal studies so suggest that it may be potentially harmful. Other drugs in the same class such as nortryptiline have shown some harm.

Given all that information, most doctors agree that you should try to stop the medicine in pregnancy, though in extreme cases it may be justified to continue it until you find a better alternative. It sounds like you may be a case like that, though this requires a long conversation with your doctor. You are correct that while the drug may or may not be dangerous, your stress and other ailments can affect the baby as well.


It may make sense to slowly taper off the drug while you start something else that may be safer in pregnancy.

I hope this helps, please let me know if you need more information.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Saul Weinreb (2 hours later)
thank you for your detailed reply and i understand it all. However it has been hard to taper off this medication as it only comes in 50mg and has now been taken off the market completely so i only have 50 tablets to go anyway. Is there anything else which is in the same category as this medicine but can get in a lower dosage? or what other type of medicine can i use instead that is pregnancy safe. I honestly don't think its safe for me and my baby at this stage to go without sleep or food for 5-6 days. I will need to use another alternative in my case.
doctor
Answered by Dr. Saul Weinreb (1 hour later)
Brief Answer:
I understand the dilemma, i'll try to help

Detailed Answer:
Hi,

There may be a few options. Sometimes the pills can be cut in half, which might be an option, but before we discuss that,
Can you tell me why you are on the medicine?

There are various indications and I need to know more before we discuss alternatives. Also, before we even discuss alternatives, please remember that I can only make suggestions, the doctor who prescribes it knows you and will be responsible to help you find the right option for you.

Regards,
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Saul Weinreb (23 hours later)
its a capsule therefore cannot be cut. which is why i have this dilemma

i have been on it for depression, anxiety, panic disorder and trauma, its assists me with sleep and eating.

yes i understand i have since spoken to my doctor about it and he has suggested something that is 25mg that i can take.

thank you
doctor
Answered by Dr. Saul Weinreb (4 minutes later)
Brief Answer:
Nice to hear that you have another option

Detailed Answer:
Hi,

Thank you for getting back to me.

Since your problem is complex, it may take you and your doctor time to find the right alternative, but there are enough options out there that you should be able to find the right medicine that is safer in pregnancy. I wish you the best of luck and a happy and healthy pregnancy. Please feel free to let me know if you have any more questions in the future.\

Regards,
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Saul Weinreb

OBGYN

Practicing since :2000

Answered : 562 Questions

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Is Surmontil intake safe during pregnancy?

Brief Answer: Stopping is good Detailed Answer: Hi, Thanks for your query. Surmontil is a pregnancy class C drug, which means that there are no studies in humans that either prove it is safe or prove that it is harmful in pregnancy. However, animal studies so suggest that it may be potentially harmful. Other drugs in the same class such as nortryptiline have shown some harm. Given all that information, most doctors agree that you should try to stop the medicine in pregnancy, though in extreme cases it may be justified to continue it until you find a better alternative. It sounds like you may be a case like that, though this requires a long conversation with your doctor. You are correct that while the drug may or may not be dangerous, your stress and other ailments can affect the baby as well. It may make sense to slowly taper off the drug while you start something else that may be safer in pregnancy. I hope this helps, please let me know if you need more information.