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Greetings! Thank you for the question. This is a very important question, relevant to many of my female patients on medications.
I see you are offline right now, so please re-contact me when you are back on so we can continue our conversation!
Regards, XXXXX XXXXX
Greetings! Great question you asked. I have a lot of patients who are either trying to get pregnant or already are, and they are taking these kinds of meds, so this is a very important question.
I'd have to say I agree with your psychiatrist. Benzos, such as clonazepam, have a higher potential risk to the developing baby than does Effexor. That is the short answer. So, getting off the med with the higher risk is the best bet.
Effexor is one of the safer drugs in pregnancy, with studies showing it has the same risk to the baby that placebo does.
But clonazepam (Klonopin) rusn a risk for cleft lip/palate and other midline defects.
That depends upon how bad your symptoms were before the meds. (I wrote a text chapter on this topic, by the way.) If you had severe symptoms before pregnancy and stop the meds prior to pregnancy, your chance of relapse is high (60-70%), with the highest risk running in the first 2 trimesters.
If your symptoms were mild, or if you had been on the medicine with no symptoms for some time, your risk of relapse is smaller.
So, it is ultimately a risk-benefit choice only you as the potential mom can make, based upon how bad you felt without the meds versus the possible risk to the baby (3-5% risk of defects on Effexor).
So, yes, the Klonopin first, then the Effexor, then the preggers!
Every once in a while we get it right. ;)
Glad to help out! Please let me know if I may be of any further service, and please click on the accept if this was useful!
Best regards! Dr. Anderson
Usually too low of a dose, but it is always possible. At that dose Effexor acts more like a SSRI than a SNRI (more on serotonin, less on norepinephrine).
So, the other option is the Effexor is just too low to be effective at controlling the anxiety.
Hope that makes sense. :)
Please let me know if you have other questions! Happy to help.