Ativan is a prescription brand name for a drug called lorazepam. Many women take benzodiazepines such as Ativan to assist with anxiety and panic disorders. It’s an effective medication for treating these common mental health issues, and it may be an important part of life for some patients. But the use of Ativan can be a cause for concern for women who are planning to get pregnant or who discover they are pregnant after taking Ativan. It is generally not recommended.
Is it safe to use lorazepam during pregnancy? Learn more about Ativan and the potential risks of using it while pregnant or breastfeeding.
Ativan Use and Abuse
Ativan is in a drug class called benzodiazepines, which are central nervous system depressants. It works by decreasing brain activity to help a person relax if they feel panic or high levels of anxiety. Ativan is primarily used to manage anxiety disorders or to provide short-term relief from anxiety symptoms. It might also be used to treat anxiety with depressive symptoms. In general, benzodiazepines are also used to treat other issues like insomnia, muscle tension, and seizures, though Ativan isn’t indicated for those purposes.
Benzodiazepines aren’t usually recommended for consistent, long-term use. According to the Food and Drug Administration, long-term use that’s longer than four months isn’t proven to be effective and may lead to tolerance. Tolerance occurs when your body adapts to the presence of the drug, making it less effective than it once was. If you’re taking Ativan, you should continue to pay attention to the drug’s effectiveness and report changes to your doctor.
As a depressant, Ativan can cause some intoxicating symptoms, similar to alcohol, with high enough doses. For that reason, benzodiazepines are sometimes used as recreational drugs to achieve a relaxing high. However, abuse and long-term use can lead to chemical dependence and addiction. Dependence develops when your body adapts to the presence of the drug and comes to rely on it to maintain a chemical balance. When you stop taking the drug, dependence can cause uncomfortable and even dangerous withdrawal symptoms.
Addiction is a disease diagnosed as a substance use disorder. It’s often identified by repeated, compulsive drug use, even if the drug is causing consequences in your life. Addiction can make it difficult to stop using the drug, especially when it’s combined with uncomfortable withdrawal symptoms.
Ativan may also be abused by taking it with other drugs. Mixing any benzodiazepines with alcohol, opioids, or other depressants can be potentially life-threatening. Combining these drugs can cause a fatal overdose. You may pass out and experience respiratory depression.
Prescribed Use of Ativan by Pregnant Women
If you’re taking a prescription drug when you become pregnant, you have a tough decision. It’s important to find out what the prescription can mean for your pregnancy and what it can mean for you and your baby.
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. 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.
But how safe is taking Ativan during pregnancy?
According to the FDA, animal studies on Ativan and pregnancy revealed an increased risk of abnormalities among babies and an increased risk of fetal loss in rabbits. It’s unclear how significant these animal studies are in treating human women with Ativan while pregnant. Still, research suggests that the use of Ativan during the first trimester of pregnancy can be potentially dangerous, leading to congenital malformations. Researchers have found that Ativan is passed to babies in the womb via the umbilical cord. If you’re taking Ativan when you become pregnant, your doctor might recommend other treatment options that can help you manage your anxiety. However, you should avoid quitting cold turkey until you speak to your doctor or a medical professional first.
Can You Use Ativan While Breastfeeding?
Breastfeeding is another time, post-pregnancy when it’s important to make sure what you are consuming is also safe for your baby. According to the FDA, Ativan can pass to babies through breast milk, so it should be avoided when breastfeeding. However, they also make note that there may be cases where “…the expected benefit to the woman outweighs the potential risk to the infant.” It may be a tough decision for some people with serious anxiety issues, and it’s important to go over all your options with your doctor.
Recreational Use in 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.
- Women may use drugs to self-medicate for certain mental health issues, lose weight, or feel alert.
- Women’s hormones may cause drugs to affect them more than men.
- Women are more at risk of overdosing or dying from drug misuse.
- Divorce, domestic violence, the death of a spouse or partner, or loss of custody of a child may cause women to use drugs or struggle with the effects of latent mental health issues.
- It may take smaller doses and less time for women to become addicted to certain substances.
- Changes in the brain and blood vessels as a result of drug use are different for women than for men.
- Women may experience changes in their menstruation patterns because of drug use.
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.
What if a Pregnant Woman Wants to Quit Using Ativan
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:
- There is uncertainty regarding use in the first trimester. Data is still needed about this at this time.
- Babies are likely to feel withdrawal from Ativan if the mother took it consistently during their last trimester.
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 and Tapering from Ativan
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:
- Vomiting and nausea
- Burning or tingling on the skin
- Visual or auditory hallucinations
- Muscle cramps
- Changes in perception of reality
Every Person is Different, but Santa Monica College Provides Some General Guidelines for How to Taper Benzodiazepines:
- Reduce dose 25 percent every two weeks until a person is taking the smallest possible dose.
- Reduce dose 25 percent during the first week and then again during the second week. Reduce the dose 10 percent per week until a person can safely stop taking their medication.
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.