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Ask Selah R, M.S. LPC Your Own Question
Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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Hi - this is a psychiatry question. I posed a few relationship

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Hi - this is a psychiatry question. I posed a few relationship questions out of desperation to Suzanne and Dr Rossi earlier this week, blaming myself for irrational feelings in my relationship. However, last night it hit me like a stone! A month ago I changed from Cymbalta (Cymgen) to Cipralex, for safety in case I fall pregnant. 2 weeks ago I started feeling totally depressed again, but didnt know why and I have been crying for the last week!

Could this changed in medication have caused me to have this relapse???

I have to tell you, that it is a relief to have made this realisation and I hope my hunch is correct.
Thank you for trusting JustAnswer with your important question.

Yes, those medications are different enough that they could have caused this "relapse" (not to mention the hormonal changes and stress level changes with pregnancies can cause emotional rollercoasters!) Cymbalta works on norepinephrine and serotonin, while Cipralex only targets serotonin. You may have "withdrawal" effects from the missing norpinephrine side for 2-4 weeks. After this point, we'd expect to have a better idea of what is left over depression that might need to be addressed by a higher dose of the Cipralex (if a higher dose is available for you given your pregnancy and your doctor's decisions regarding what is a safe dose in your trimester/stage).

Best wishes,
Selah R, M.S. LPC and other Mental Health Specialists are ready to help you
Customer: replied 6 years ago.

Sorry Selah - I dont want to go back onto Cipralex after I KNOW that 60mg of Cymbalta works. Is Cymbalta not safe at all during pregnancy (this will not be my baby, I will be a surrogate)????? I am not pregnant yet.


Also, If I do go back onto Cipralex and up the dosage, will the depression go do you think (cipralex did work before) ?

SSRIs (like Ciprakex) and SNRI/SSRIs (like Cymbalta) are not studied in pregnant women in a scientifically controlled way (which us true for most prescription medications because no one wants the risk). Most evidence appears to show that the use of these medications can be considered if the potential benefits outweight the risks. Maternal depression causes stress and physical changes in the body, as well as change how well pregnant women take care of themselves. Therefore it is not uncommon for antidepressants to be deemed worth the risk.

Most reports of birth defects appear to show the same risks in both of these medications when taken in the last half to last third of pregnancy. These are still rare issues abd most doctors will recommend that you not breastfeed while on antidepressants. So if you want to have the safety (because it works) of Cymbalta if the depression gets unmanageable then talk to your Ob/Gyn and Psychiatrist about your concerns.

Selah R, M.S. LPC and other Mental Health Specialists are ready to help you