There has been some conflicting evidence concerning the safety of taking Xanax (alprazolam) during pregnancy. Women who use Xanax while pregnant or planning to get pregnant are urged to discuss this with a health provider or addiction specialist. These experts can help you determine the best course of action and whether there is a need for professional treatment and under what conditions.
Xanax is a benzodiazepine commonly used to treat anxiety, panic disorders, seizures, and insomnia. Women who experience these conditions and are pregnant or attempting to conceive are right to be concerned about using Xanax. Unfortunately, there is no simple answer, as research that has examined alprazolam use during pregnancy has so far yielded conflicting findings.
There is also contradictory evidence regarding stress and its effects on a baby in utero. Some studies have found that neither generalized anxiety nor panic disorder were associated with adverse outcomes in newborns. Still, other research has suggested that severe versus mild or moderate stress may significantly affect an unborn child.
Before making a decision, it is important to talk to a health provider who can perform a risk-benefit analysis and educate patients on current research regarding Xanax and pregnancy. Those women who feel that the baby may be better off if they discontinue Xanax use, detox, and long-term drug dependency treatment may be an appropriate choice.
Potential Effects on an Unborn Baby
In many instances, when a mother uses a substance, the fetus is also exposed to it. Exposure occurs because psychoactive or intoxicating substances are likely to pass through the placenta to the baby. All psychiatric medications travel through the placenta, and some studies have revealed an increased risk of certain congenital disabilities. However, the risk of these effects resulting from prenatal exposure to these drugs may not be as high as previously thought.
Some believe that using Xanax while pregnant may increase the risk of certain congenital disabilities, but research hasn’t yet determined the precise amount of risk. One study found that out of 542 women who had used Xanax while expecting, there were just 13 live births with congenital anomalies and 47 miscarriages. These numbers were not statistically significant, but the study itself wasn’t considered large enough to be conclusive.
Another report posited that the risk of cleft lip and palate among women who used benzodiazepines during the first trimester was relatively small—about 0.7%.
Yet another clinical review from the 1970s suggested a heightened risk of facial clefts and other malformations. However, researchers did acknowledge that many of the women looked at in the study had complex psychological issues and took multiple medications, which could have contributed to the development of defects.
Overall, the preponderance of research into this correlation found that the majority of infants were born normally. The most significant risk appeared to be using benzodiazepines in the third trimester or during labor. Although findings from several studies revealed some birth defects in newborns, no causal relationship has been found between Xanax use and congenital anomalies.
Moreover, additional studies and extensive research need to be performed if we are to find a more definitive answer. Currently, most experts believe the risk to be relatively small—but there may still be a risk. For many pregnant women, using psychoactive substances such as Xanax is worrisome, and understandably, would rather err on the side of caution.
Concerning the use of psychoactive substances during pregnancy, much of the desire to abstain may have less to do with the actual risks involved and more to do with the fear of potentially adverse outcomes. That is, if a baby is born with birth defects, the mother tends to question whether she could have done something (or avoided something) to prevent it from happening. Many women would rather not have to wonder if their child’s defect(s) was preventable, or if it resulted from something potentially harmful that they chose to put in their bodies.
Long-term benzodiazepine use can lead to dependence in both the mother and the unborn child, especially when used late in pregnancy and in large doses. Some babies may exhibit withdrawal symptoms at birth, which may include the following:
- Decreased muscle tone
- Reluctance to suckle
- Sleep apnea
- Bluish or purplish skin
- Insensitivity to cold
- Seizures (rare)
Another potential complication for a newborn is hypotonia, commonly known as floppy baby syndrome.
Symptoms of hypotonia may include the following:
- Weak cry or voice
- Impaired respiration
- Feeding problems
- Poor head control
- Limp and hanging limbs
In some instances, because of the risks of discontinuing Xanax related to both the mother’s and the fetus’s safety, a doctor may continue prescribing it or other benzodiazepines to a dependent mother throughout her pregnancy, even if her clinical symptoms have subsided.
It’s important to remember there is still some controversy surrounding the safety of the use of Xanax while pregnant, and many health providers continue to prescribe it to mitigate symptoms of anxiety and panic. In fact, it is thought that as many as one-third of all pregnant women receive psychiatric drugs to manage mental health conditions diagnosed before pregnancy.
Risks of Untreated Anxiety
Symptoms of anxiety can worsen if left untreated and can negatively affect both the infant and the mother. For example, pregnant women who have an untreated panic disorder may have an increased risk of miscarriage and premature birth. Research has also found that an increase in anxiety disorder symptoms is common both before and after a woman gives birth.
Although data is somewhat limited, it appears that specific anxiety disorders, including generalized anxiety, occur with higher frequency in women postpartum than in the general population. If severe enough, this could impair a mother’s ability to care for her child, and in extreme cases, she might even endanger it.
There is also an increased risk of worsened anxiety during pregnancy and the postpartum period. This may be true whether the mother is currently being treated for mental health issues or not. According to the Centers for Disease Control and Prevention, research shows that around 1 in 8 women experience symptoms related to postpartum depression.
Discussing the pros and cons of stopping Xanax use with a health professional is ultimately the best way to make an informed decision concerning both the baby and the mother’s health.
Getting Treatment for Drug Dependence
If you are attempting to get pregnant or considering it and are dependent on a benzodiazepine and want to quit, you may benefit from professional help. The long-term use of Xanax is almost guaranteed to result in some dependence level, and most patients need to undergo a tapering schedule. However, medical detox is also sometimes used to expedite this process.
Just Believe Detox and Just Believe Recovery feature integrated programs designed to treat all aspects of an individual’s emotional well-being, including issues related to substance use and mental health conditions, such as anxiety. These programs include research-based services, including behavioral and experiential therapies, individual and family counseling, peer group support, mindfulness therapy, aftercare planning, and more.