From the Guidelines
Xanax (alprazolam) is generally not considered safe during pregnancy and should be avoided unless the potential benefits clearly outweigh the risks. This medication belongs to the benzodiazepine class and is classified as FDA Pregnancy Category D, indicating evidence of fetal risk 1. Using Xanax during pregnancy has been associated with increased risks of congenital malformations, particularly when used in the first trimester. Additionally, babies exposed to benzodiazepines late in pregnancy may develop withdrawal symptoms after birth, including irritability, high-pitched crying, tremors, and feeding difficulties. Some key points to consider when managing anxiety during pregnancy include:
- The potential risks and benefits of medication use during pregnancy, as outlined in studies such as 1 and 1
- The importance of non-medication approaches, such as cognitive behavioral therapy, in managing anxiety during pregnancy
- The need for careful consideration and monitoring when using any medication during pregnancy, as recommended in 1 If you're currently taking Xanax and are pregnant or planning pregnancy, do not stop taking it abruptly as this can cause withdrawal symptoms; instead, consult your healthcare provider immediately to discuss safer alternatives for managing anxiety during pregnancy. Your doctor may recommend non-medication approaches or, if medication is necessary, might suggest options with better safety profiles during pregnancy, such as those outlined in 1.
From the FDA Drug Label
Risk of Fetal Harm Benzodiazepines can potentially cause fetal harm when administered to pregnant women If alprazolam tablets are used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus Because of experience with other members of the benzodiazepine class, alprazolam tablets are assumed to be capable of causing an increased risk of congenital abnormalities when administered to a pregnant woman during the first trimester. Because use of these drugs is rarely a matter of urgency, their use during the first trimester should almost always be avoided
Xanax is not safe for pregnancy, especially during the first trimester, due to the potential risk of fetal harm and congenital abnormalities 2.
From the Research
Xanax Safety During Pregnancy
- Xanax, also known as alprazolam, is a benzodiazepine commonly prescribed for anxiety and panic disorders 3.
- The use of benzodiazepines, including Xanax, during pregnancy has been associated with adverse outcomes, such as preterm delivery and low birth weight 3, 4, 5.
- A study published in 2022 found that exposure to alprazolam during pregnancy was significantly associated with spontaneous abortion, low birth weight, and Apgar score at 1 min ≤ 7 4.
- Another study published in 2017 found that maternal benzodiazepine use was associated with cesarean delivery, low birth weight, and use of ventilatory support for the newborn 5.
- The management of benzodiazepine withdrawal during pregnancy poses unique challenges, and guidelines for detoxification during pregnancy have been suggested 6.
- While the potential risks of antipsychotics during pregnancy and lactation have been discussed, the effects of benzodiazepines like Xanax on the fetus and infant are still being studied 7.
Adverse Outcomes Associated with Xanax Use During Pregnancy
- Spontaneous abortion 4
- Low birth weight 4, 5
- Preterm delivery 3, 5
- Cesarean delivery 5
- Use of ventilatory support for the newborn 5
- Apgar score at 1 min ≤ 7 4
Considerations for Xanax Use During Pregnancy
- The potential benefits of Xanax use during pregnancy must be weighed against the potential risks to the fetus 7.
- Women requiring treatment with Xanax during pregnancy should be closely monitored by their medical providers 6.
- Alternative strategies for anxiety management during pregnancy may be considered to minimize the risks associated with benzodiazepine use 3.