Can an antidepressant drug overdose during early pregnancy cause birth defects in the fetus?

Question

Hello doctor,

I am 14 weeks pregnant. I have had irregular periods, and my LMP was around four months back. When I was 3 weeks 6 days pregnant (based on ultrasound), I had an overdose of about 1000 mg of tablet Trazodone. I came to know that I was pregnant only two days later. I understand that the tablet Trazadone is a class C drug, and I stopped using it once I found out I was pregnant. Can this overdose episode cause birth defects in my baby, or was I still in the "all or nothing" period of fetal development? I am concerned.

Kindly advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Congenital malformations may be caused by genetic factors, environmental teratogens, or both that occur during embryogenesis. However, common congenital malformations have a multifactorial inheritance. During the first two weeks of gestation, teratogenic agents kill the embryo rather than causing congenital malformations. Most severely affected embryos spontaneously abort during the first eight weeks of pregnancy. During organogenesis, which occurs between 15 to 60 days, is very important as teratogens are more likely to cause major congenital malformations.

Accidental exposure to 1000 mg tablet Trazodone does not increase the rate of major malformations. There was no increased risk of miscarriage, stillbirth, or having a low birth-weight baby in a mother who had taken the tablet Trazodone or a related medicine during pregnancy.

Assuming that you have done an NT (nuchal translucency) scan at 13 weeks and it went well, it is recommended to get a target scan at 19 to 20 weeks or an early anomaly scan at 16 weeks by a fetal medicine specialist to look for any congenital abnormalities thoroughly. In addition, you can get a NIPT (noninvasive prenatal testing) and Quad screen at 18 to 19 weeks to look for any genetic and placental abnormalities.

I hope this helps.

Thank you.