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Smoking and Tobacco

Use of Welbutrin during pregnancy

07/23/2007

Question:

My daughter`s OB/GYN has suggested the use of Wellbutrin to help her stop smoking during her pregnancy. We are concerned about the dangers of the medication being worse for the baby than the smoking (which she has cut way back on). What do you feel about this and the safety of the medication?

Answer:

These next statements are going to seem harsh, and I suspect many people might not like them, but hundreds of scientific studies now back them up. Smoking around an infant or child is child abuse. Smoking while pregnant is worse.

According to last year's US Surgeon General's report, pregnant women who smoke have substantially higher rates of miscarriage, stillbirth, premature labor, underweight babies, placenta problems, premature rupture of membranes and newborn death. Moreover, those babies who survive are much more likely to die of Sudden Infant Death Syndrome, develop Attention Deficit Disorder and have long term behavior problems.

On top of that, women who smoke during pregnancy are very likely to continue to smoke after pregnancy. Those kids who live in the same house as a person who smokes indoors generally have many more colds and sinus infections, ear aches, asthma attacks and pneumonia, as well as reduced lung function.

So would I rather have this mother-to-be taking Welbutrin than smoking? Yes! But that is not as much an endorsement of Welbutrin during pregnancy as it is an abhorrence of smoking while pregnant. I suspect her doctor feels the same way.

Welbutrin, also known by the generic name, bupropion, has a primary use is as an antidepressant. It works to increase levels of two important brain chemicals: dopamine and norepinephrine. Small studies of women who've used Welbutrin during pregnancy show no obvious birth defects in the short term, but long term studies on these children are not yet available. Welbutrin has a number of possible side effects that your daughter should discuss with her doctor.

My advice is to stop smoking without Welbutrin. Failing that, Welbutrin is a better choice than continuing to smoke. Also important is that no one smokes around your daughter, including the baby's father or grandparents. She can get further help by calling Ohio's free Quitline: 800-QUIT-NOW (800-784-8669) where trained and highly experienced counselors can help her through nicotine withdrawal.

Parenthood is a long trial. This is the first test.

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Response by:

Rob  Crane, MD Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University