Psychiatry & Psychology--General/Paxil in pregnancy


Good morning,

I am thinking of getting pregnant and I take paxil 30 mg a day. I have tried getting off several times in the past with no luck. What are the real risks? I have heard there is an increased risk of birth defects but that the percentage is still very low. Please can I have your opinion. Thank you, Nicole

Dear Nicole,
If you are planning a pregnancy & are already a case of depression, I would suggest the use of older antidepressants such as nortriptyline. In the newer drugs, sertraline has the least placental exposure. Fluoxetine is also useful. Paxil or paroxetine is associated with cardiac malformations.
It is best to consult your treating psychiatrist & discuss your plans to get pregnant.
It is advisable to use lowest effective dose of the drug. If you have no chance of relapse, then even stopping the medicines gradually is an option. However if there is a risk of relapse, you can continue the same drug.
Dr. Kalra

Psychiatry & Psychology--General

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Dr. Gurvinder Kalra, MD


I can answer questions related to Psychiatric illnesses, their management, relationship issues etc.


I have completed my Masters in Psychiatry. Currently I am working as an Assistant Professor in the Department of Psychiatry at L.T.M.Medical College & L.T.M.General Hospital, Mumbai, India.

1. Kalra G, Bhugra D. Mutual learning and research messages: India, UK and Europe. Indian J Psychiatry 2010;52(7 Suppl 3):S56-63. [doi: 10.4103/0019-5545.69211] 2. Kalra G, Gupta S, Bhugra D. Sexual Variations in India: A view from the west. Indian J Psychiatry 2010;52(7 Suppl 3):S264-8. [doi: 10.4103/0019-5545.69244]

MD Psychiatry, Diploma in Psychiatry, M.B.B.S

Awards and Honors
1. A.V. SHAH BEST RESEARCH PAPER AWARD, at the 38th Annual Conference of Indian Psychiatry Society- West Zone Branch, Nagpur, India, 13th Oct 2007. 2. BOMBAY PSYCHIATRIC SOCIETY SILVER JUBILEE NATIONAL AWARD, at the 60th Annual National Conference of Indian Psychiatric Society (ANCIPS), in Kolkata on 4th January, 2008. 3. 2nd prize in the free paper session for presenting the paper “Sexual Attitudes & Behaviours in Individuals above 50” at the 24th National Conference of Sexology held in Jaipur in September, 2008. 4. BHAGWAT NATIONAL AWARD, for Co author of “Study of Emotional Intelligence in Medical Postgraduates”. The Study was presented in the 61st Annual National Conference of Indian Psychiatric Society (ANCIPS), in Agra on 6th January, 2009. 5. 1st prize in the Dr.S.M.Lulla Post Graduate Quiz held in July 2006 at Department of Psychiatry, T.N.M.C. Mumbai, India. 6. Won the Post Graduate Debate on “Involuntary Treatment in Psychiatric Patients is Unjust”, 2nd March 2008, T.N.M.C. Mumbai, India.

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