Many women take benzodiazepines such as Ativan to assist with panic disorders.
Use of Ativan can be tricky for women who are planning to get pregnant or who discover they are pregnant after taking Ativan. It is generally not recommended.
Ativan works by decreasing brain activity to help a person relax if they feel panic or high levels of anxiety.
The drug is often used without a prescription. This type of misuse often accompanies the misuse of other substances.
On November 2018, writer Laura Turner wrote for Slate about her experiences taking Ativan during pregnancy. Turner had suffered several miscarriages before her fourth pregnancy and decided to take Ativan because she felt that not taking it would make her panic attacks worse.
Turner described the shame some women face when taking prescription medications during their pregnancy. Her research concluded that some doctors might outright refuse to prescribe Ativan to a woman who is pregnant even if she truly needs it.
In the end, Turner’s baby was fine. She wrote that not taking anti-anxiety medications could worsen mental health in some newly pregnant women.
Recreational use of Ativan by pregnant women is different.
The National Institute on Drug Abuse (NIDA) mentions a few ways recreational use and misuse of drugs are different for women than for men.
Use of benzodiazepines is not recommended for women who are pregnant or breastfeeding.
Even if used with a prescription, people who take Ativan regularly can experience withdrawal when stopping use. Babies can also experience withdrawal.
Many women who use Ativan in any manner may decide to quit if they learn they are pregnant or if they decide they want to get pregnant. Use of benzodiazepines was once thought to increase the chance of birth defects in babies, such as cleft palates or heart problems.
The Journal of Obstetrics and Gynaecology conducted several studies on the risk of congenital defects and found they were minimal. A 2017 report from NPR says scientists are still trying to find out how benzodiazepines may affect women and their fetuses in other ways.
Even though the risks to the fetus are minimal, women may want to quit using benzodiazepines for the following reasons:
Anyone who wants to quit Ativan should not do it cold turkey or on their own. This is especially true for people who have been using Ativan for longer than a few weeks.
A doctor can help pregnant women taper off their dose and reduce the chance of withdrawal symptoms for both the mother and fetus.
Withdrawal from Ativan is common because it can cause dependency and tolerance if taken for a long time. This means a higher dose of Ativan is needed to feel its effects.
A doctor is best equipped to help anyone who wants to quit taking Ativan, and this includes people who take it for nonmedical reasons.
Doctors will generally recommend a tapering schedule, which means they will slowly reduce a person’s dosage of Ativan so they can be more comfortable and avoid some of the worst symptoms of withdrawal. Symptoms could include the following:
Every person is different, but Santa Monica College provides some general guidelines for how to taper benzodiazepines:
Doctors will supervise each person to make sure they do not suffer from withdrawal symptoms during tapering, including cravings. This will help people avoid relapse.
Therapy is recommended during this process as well.
Pregnant women require specialized care. Choose a physician or treatment program that has experience treating pregnant women if you need to taper off Ativan.
Since pregnancy presents a more complex treatment regime, catered treatment is needed.
(January 2010) Alcohol, Benzos, and Opiates—Withdrawal That Might Kill You. Psychology Today. from https://www.psychologytoday.com/us/blog/all-about-addiction/201001/alcohol-benzos-and-opiates-withdrawal-might-kill-you
(January 2011) The Fetal Safety of Benzodiazepines: An Updated Meta-analysis. Journal of Obstetrics and Gynaecology Canada. from https://www.jogc.com/article/S1701-2163(16)34772-7/pdf
(September 2017) Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety. NPR. from https://www.npr.org/sections/health-shots/2017/09/18/551020800/xanax-or-zoloft-for-moms-to-be-a-new-study-assesses-safety
(September 2015) Pregnancy effects of 4 drugs, including marijuana. AL. from https://www.al.com/news/index.ssf/2015/09/pregnancy_effects_of_4_drugs_i.html
(January 2019) Benzodiazepines Uses, Indications, and Side Effects. Verywell Mind. from https://www.verywellmind.com/the-benzodiazepines-378909
(November 2018) Should Pregnant Women Take Anti-Anxiety Medication? Some Have No Choice. Slate. from https://slate.com/technology/2018/11/pregnancy-anxiety-medication-ativan.html
(August 2018) Substance Use in Women. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugfacts/substance-use-in-women
(December 2015) Pregnant women and substance use: fear, stigma, and barriers to care. Health and Justice. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5151516/
(January 2014) Tapering Benzodiazepines. Santa Monica College. from http://www.smchealth.org/sites/main/files/file-attachments/benzodiazepinetaper08-12-13.pdf