Xanax, Pregnancy and Breastfeeding

Is it OK to use Xanax during pregnancy and breastfeeding? Usually, the risks of using it outweigh the benefits, and there are better alternatives available.

Pregnancies can be stressful. While pregnant, women and their partners must attend multiple doctor’s appointments, figure out how to pay for the baby, decide in what manner to give birth and prepare their home for their infant that’s on the way. These compiled responsibilities could cause women, especially those already dealing with the emotional rollercoaster of pregnancy, to experience bouts of anxiety.

To combat anxious feelings, many pregnant women use anti-anxiety medications like Xanax. While the drug is designed to reduce anxious feelings, it can also compromise the safety of the mother and her fetus. Before using the drug, it is important to know the risks of taking Xanax while pregnant.

What Is Xanax?

The brand name of the benzodiazepine alprazolam, Xanax is a prescription medication approved by the Food and Drug Administration to treat anxiety and panic disorders. The drug calms individuals by decreasing abnormal excitement in the brain and depressing the central nervous system.

While the medication can cause sedation, alprazolam contains euphoric properties that can lead to a high, which has resulted in widespread misuse. According to the Substance Abuse and Mental Health Services Administration, Xanax is the most common benzodiazepine to be associated with emergency department visits involving drug misuse.

According to the National Survey on Drug Use and Health, an estimated 497,000 Americans ages 12 or older misused sedatives like Xanax in 2016. That year, adults aged 18 to 25 had the highest percentage of past-year sedative use when compared with other age demographics.

The side effects of using Xanax include:

• Drowsiness
• Lightheadedness
• Dizziness
• Nausea
• Dry mouth
• Joint pain

Alprazolam can also cause overdose. Symptoms of Xanax overdose include confusion, shortness of breath, speech problems, trouble with coordination and balance, hallucinations and seizures. If a pregnant loved one exhibits any of these symptoms after taking the medication, call 911 immediately.

Harms of Taking Xanax While Pregnant

During pregnancy, a number of women use prescription medications. According to the Centers for Disease Control and Prevention, nearly 25 percent of pregnant women ages 15 to 44 reported using prescription medicines in the past month. However, taking certain medications during pregnancy can be harmful to the mother as well as the baby.

Xanax isn’t safe to take during pregnancy. The medication is labelled by the Food and Drug Administration as a Pregnancy Category D drug, which means that it can harm the fetus. Other category D substances include ACE inhibitors and tetracyclines.

During the first one to three months of pregnancy, taking Xanax could raise the risk for birth defects. These deformities could include cleft palate, cleft lip or other serious birth problems that can cause long-term health complications.

A study published in the journal Obstetrics and Gynecology examined the effects of fetal alprazolam exposure during the first trimester. Of the 411 patients from whom data was collected, there were 13 babies born with congenital anomalies and 47 miscarriages.

Xanax use late in a pregnancy can also result in your baby experiencing floppy infant syndrome, a condition in which infants are born with weak muscles. Newborns with this disorder cannot control their arms, legs and head for up to three weeks after birth. Floppy infant syndrome can also affect a baby’s heart rate, breathing and body temperature.

Babies Born Addicted to Xanax

Alprazolam is an addictive drug. Misusing the medication, including taking large doses of the drug, for extended periods of time can lead to drug addiction. While a substance use disorder greatly affects a mother’s health, it can also transfer to the fetus.

Taking Xanax during months four to nine of the pregnancy can cause a baby to be born dependent on the benzodiazepine. If an infant is born dependent on Xanax, he or she can experience painful drug withdrawals.

When withdrawing from benzodiazepines like Xanax, babies could endure:

• Dehydration
• Breathing problems
• Trouble feeding
• Skin discoloration (cyanosis)
• Breath-holding spells

Infants born dependent on benzodiazepines can also deal with irritability, sleep disruption and, in extreme situations, seizures. The effects of drug withdrawal can last several weeks or months. To keep your baby from being born dependent on alprazolam, talk to your doctor about alternative ways to manage your anxiety.

Alternatives to Taking Xanax While Pregnant

For pregnant women, anxiety isn’t uncommon. While Xanax isn’t safe to take during pregnancy, you should not ignore anxious feelings. An untreated anxiety disorder can cause health problems in mothers and infants. For example, anxiety can prevent you from eating properly, which can restrict an unborn child from receiving sufficient nutrients.

Instead of taking alprazolam, talk to your doctor about alternatives methods for treating anxiety problems. He or she may recommend selective serotonin reuptake inhibitors, which have shown to be safer options for reducing anxiety. Psychotherapy options like cognitive behavioral therapy can also help expecting mothers deal with anxiety.

Other healthy methods for reducing stress and anxiety include:

• Exercise
  • One of the healthiest outlets for dealing with stress, exercise releases endorphins that improve your mood and lower your body’s stress hormones. Physical activity can also build muscle and improve sleep.
• Reduce caffeine intake
  • Found in coffee and energy drinks, caffeine is a stimulant that can lead to anxiety when taken in high doses. If you use coffee during pregnancy, be sure to drink it in moderation.
• Spend time with family and friends
  • Social support can help you deal with anxiety. Spending time with loved ones can give you a sense of self-worth and belonging. For women, spending time with friends and children has shown to release the natural stress reliever oxytocin.
• Practice mindfulness
  • Mindfulness activities, like meditation, can help reduce negative thinking and anxiety. One of the most popular mindfulness activities is yoga, which has shown to reduce anxiety by lowering blood pressure, reducing heart rate and easing respiration.
• Jot down your thoughts
  • Jotting down your thoughts can improve your mood. According to a report by the University of Rochester, writing about your emotions can help you manage anxiety, reduce stress and even cope with depression.

Pregnant women addicted to Xanax must not suddenly stop using the drug. When grappling with addiction, quitting a substance cold turkey can bring about harmful withdrawal symptoms in individuals. Instead of abruptly quitting, talk to a doctor about your situation. He or she will likely create a plan for gradually tapering off the substance, which reduces the risk for severe withdrawal symptoms.

If you grapple with Xanax misuse, call The Recovery Village. At The Recovery Village, trained medical professionals can assist you in reducing substance use. Each patient receives a treatment plan catered to his or her specific needs. With locations across the United States, The Recovery Village can help you heal. By making the call, you can go on to receive evidence-based treatment in a safe and secure environment.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP

Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more