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Dr_Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience:  Psychiatrist
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I am on 75mg Effexor XR and clonazepam 0.25 in morning an at

Customer Question

I am on 75mg Effexor XR and clonazepam 0.25 in morning an at night. I want to come off these meds to get pregnant. My psychiatrist wants me off the clonazepam first since I'm most dependent on that and then the Effexor. I want a secon opinion. I think I should do the Effexor first and then the clonazepam.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr_Anderson replied 5 years ago.
Dr_Anderson :

Greetings! Thank you for the question. This is a very important question, relevant to many of my female patients on medications.

Dr_Anderson :

I see you are offline right now, so please re-contact me when you are back on so we can continue our conversation!

Dr_Anderson :

Regards, ***** *****

Customer: Hi!
Dr_Anderson :

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.

Customer: Thanks I want to do this right.
Dr_Anderson :

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.

Dr_Anderson :

Effexor is one of the safer drugs in pregnancy, with studies showing it has the same risk to the baby that placebo does.

Dr_Anderson :

But clonazepam (Klonopin) rusn a risk for cleft lip/palate and other midline defects.

Dr_Anderson :

*runs* rather

Customer: Well I don't want to be on either medication while pregnant. Is this still the best plan to take?
Customer: Quit clonazepam first then Effezor then try to get pregnant?
Dr_Anderson :

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.

Dr_Anderson :

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.

Dr_Anderson :

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).

Dr_Anderson :

So, yes, the Klonopin first, then the Effexor, then the preggers!

Customer: Ok sounds good. Thanks so much for your help! I guess the doctor was right!!!!
Dr_Anderson :

Every once in a while we get it right. ;)

Dr_Anderson :

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!

Dr_Anderson :

Best regards! Dr. Anderson

Customer: Real quick could 75mg cause anxiety in me? Or is it too low of a dose?
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).

Dr_Anderson :

So, the other option is the Effexor is just too low to be effective at controlling the anxiety.

Dr_Anderson :

Hope that makes sense. :)

Dr_Anderson :

Please let me know if you have other questions! Happy to help.

Dr_Anderson and other Mental Health Specialists are ready to help you