Benzodiazepines such as Alprazolam (Xanax) are classified as a Pregnancy Category D drugs that have shown a clear risk of causing congenital malformation when taken during the first trimester and their use during pregnancy is discouraged unless the risk posed by discontinuation of the drug out weights its benefits.
Specifically there is an about doubling of the risk for orofacial clefts (cleft palate, or lip) from nearly 1 in 700 births to just under 2 in 700. As you are in your twelfth week there is probably nothing you can do now to moderate that risk given that Xanax should be weaned off slowly over a period of weeks or months and never quit abruptly.
There is some evidence that folic acid (
Shaw et al, 1995) can significantly reduce the risk of orofacial clefts, as can moderate intake of other vitamins and minerals, so if you've been following the usual recommendations, the risk the Xanax poses to your baby may be somewhat less.
In addition, taking benzodiazepines late in pregnancy the baby may experience withdrawal symptoms shortly after birth. These symptoms may include decreased muscle tone, breathing and feeding difficulties, and decreased body temperature. These need to be prepared for at delivery.
However, untreated anxiety and depressive disorders can also pose risks to both mother and child. For the child these can range from: learning difficulties, slower development and possibly autism, to premature birth, stillbirth, and death during the first months. There is also evidence that maternal anxiety during gestation increases the risk that the child will develop anxiety, depression or other mental disorders later in life. I've explored many of these at my own
Caution: If you have been taking benzodiazepines for more than a few weeks you may become physically dependent on the medication. When a benzodiazepine is discontinued you can get symptoms similar to those of an alcoholic who suddenly stops drinking - tremors, cramps, convulsions, sweating, vomiting and rebound insomnia. Sudden discontinuation may trigger seizures. Do not stop taking benzodiazepines unless directed to do so by your health care provider.
NOTE: I am not a doctor, and more importantly, I'm not *your* doctor so the above advice is necessarily of a general nature which may or may not apply to you. Always consult your health provider before acting on anything you've read here.
Omg this is so terriable i am about 15 weeks pregnant and have been on xanax the whole entire time i try not to take more then one 1mg a day but my anxiety is disableing I cant go to work or sleep or eat nothing without it not to metion i have been on them for a long time so the withdraws are terriable and I am also on methodone I dont feel this baby has much of a chance to turn out healthy I'm so scared I'll never fogive Myself.
Has your doctor told you to discontinue Xanax (alprazolam), or are you doing this yourself?
If the latter, then maybe you need to reconsider. At least talk to your doctor about the advisability of discontinuing. Your doctor may decide that an uncontrolled anxiety disorder and/or the stress of withdrawal may be potentially more harmful to your baby than continuing with the Xanax.
I am 17 weeks pregnant, 25 years old and I have been on xanax for 10 years now. My doctor wants me to continue taking it but only on an 'as needed' basis. I have a panic disorder and have been unemployed because of it for two years now. My anxiety isnt nearly as bad since i rarely leave home... I still get 120 1mg pills every month but i only take a very small fraction of them...
Still I worry so much about how my baby is... and Ive cut down to about 1 maybe 2 mgs a week
I understand you're concerns, PixieSascha. However, there are very real potential physical risks to the fetus from maternal stress associated with anxiety and depression, so don't forgo the Xanax if you need it, especially now that you are well into the pregnancy. You might find these articles useful: http://www.anxietyinsights.info/index.cfm?search=pregnancy
I am concerned that you are house bound. Agoraphobia is often associated with panic disorder and needs to be specifically treated. Both antidepressants and/or one of the cognitive-behavioral therapies may give you better control of your panic disorder and agoraphobia than benzodiazepines alone. Perhaps something to discuss with your doctor once the baby is born.
I am 15 weeks pregnant now. I also have been taking xanax for about 3 years now. Before I became pregnant I was taking 4 mg of xanax a day. Now i'm down to 1 mg/ day. Sometimes I can take .5 mg/ day. I'm very worried about the health of my baby as well. But like you I have severe Anxiety & Panic Disorder. My doctor wants me off of the medicine, but I'm not sure I will be able to get off of it completely. I'm very scared too.
I am currently 13 weeks pregnant. Prior to becoming I rarely took my xanax. I used to have such bad anxiety I refused to leave the house, got fired from a list of jobs, and had someone call 911 at least 5 times due to me completely panicking! At the time where I became pregnant I was finally gaining control back. I went from taking 2 to 4 mg's a day to maybe .25 mg's a week. Previously I had 5 miscarriages and was told my xanax use may have contributed to them. These losses were all at 8 weeks or prior. Now that I am 13 weeks, I have terrible anxiety again. I have my "emergency" xanax. I found myself taking small pieces on a few occasions. When I spoke with my genetics counselor she told me xanax has dependancy issues associated with it and therefore frowned upon but she had no other issues with my past use. I neglected to tell her I took a small piece the day before the appointment because I feel guilty. Obviously the genetic counselor knows everything about medicine and for her to tell me that she had no worries makes me more scared than ever because looking online I see everyone saying it is dangerous and there are issues. I am terrified now I have done something to my baby. With all of my anxiety issues I dont know what I would do if there are problems..
I have been on Xanox for more than 10 years now but I immediately began the journey of decreasing my intake of Xanox right away. I have PTSD and Acute Anxiety due to growing up in Colombia and seeing a lot of acts of violence perpetrated on myself and others. I have seen things that I cannot even mention. I still felt that it was my duty if I am any type of human with a conscience that I must have high regard also for my baby and not just myself. I found that everytime I felt scared about decreasing my dose, I would think about my baby and found strenghth I didn't know I had. I know that abruptly stopping completely can bring terrible withdrawal symtoms and can even damage you long term. However decreasing your dose by 0.5 mgs every two weeks is what I have been told is best to do. I would recommend that when you get down to 0.5 ms to drop down to 0.25 mgs for the last two weeks rather than go from 0.5 to nothing. And remember... if you were prescribed this medication in the first place that most likely means that your anxiety is much, much worse than the average person. Obviously, I know. This should just remind you, though, that you will have to work a little extra harder at staying calm and should have a plan as to how you will handle panic/anxiety once you have weaned yourself completely off the Xanox. I am in my last two weeks now of taking 0.25 mgs per day. I didn't even know I was pregnant until 2 weeks ago. Somehow I went from taking 1.5 mgs per day to immediately only taking 0.5 mgs per day and last night dropped again to only 0.25 mgs per day. I know I said I would recommend decreasing the dose 0.5 mgs every two weeks but at that rate it would have taken me another two weeks to be where I am today and I am desperate to quit but without the horrible withdrawal symtoms. I am also afraid that going cold turkey would hurt my baby. It's important to do what's best for BOTH mama AND the baby. Good luck to all the women going through the same challenge. Here are a few things that help me to keep my anxiety levels lower that are natural. 1) Drink LOTS of water 2)Try to get at least 30 mins of exercise DAILY 3)Listen to relaxing music 4)Find something you like to do that motivates you or simply makes you feel better such as yoga, art, cooking (and remember you don't have to be good at it, just have to enjoy it). 5)Inhale deeply and slowly 6)Express your worries/anxiety with a friend/therapist that is a good listener and can help you find solutions to any problems. Sometimes just expressing your concern with another helps you to start to feel better. Things I would recommend not doing: 1)Don't watch or listen to anything that is about the news. Most news is bad news and riddled with fear. 2)Don't drink coffee or anything caffinated after 3 pm. 3) Don't watch horror movies and/or movies that cause you to have a negative gut reaction. 4)Don't allow anyone to upset you and if you feel like they are beginning to upset you then step away from them. Remember that whatever you feel your baby will most likely feel too. 5)Don't listen to sad, negative, violent music because music can stirr up a lot of emotions too.
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