Benzodiazepines in Pregnancy

Abstract

Benzodiazepine use and dependence are on the rise as well as the number of deaths attributable to the combination of opioids and benzodiazepines. Anxiety, the most frequent condition for which benzodiazepines are prescribed, occurs commonly, and is increasingly noted to coincide with pregnancy. Use of both benzodiazepine anxiolytics and anxiety in pregnancy is associated with preterm delivery and low birth weight. Short-term neonatal effects of hypotonia, depression, and withdrawal are described but long-term sequelae, if any, are poorly understood. Benzodiazepines are associated with physical dependence and withdrawal symptoms which can be serious. To avoid withdrawal, tapering off these medications is recommended. What is known about the pharmacology and pharmacokinetics, pregnancy implications, tapering schedules, and alternative strategies for anxiety are discussed.

Transcranial Electrical Stimulation for Relief of Peripartum Mental Health Disorders in Women Undergoing Cesarean Section With Combined Spinal–Epidural Anesthesia: A Pilot Randomized Clinical Trial

“…To avoid these hazards, people often use pharmacological and non-pharmacological treatments. It is well known that benzodiazepines and benzodiazepine-related drugs are generally prescribed for the treatment of anxiety disorders ( 43 ). These drugs have anxiolytic, hypnotic, and anticonvulsant properties and may relieve symptoms in the short term.…”

Etizolam levels in maternal serum, cord blood, and breast milk during pregnancy and lactation: A case report

“…However, a causal relationship between etizolam and/or trazodone use during pregnancy and neonatal respiratory distress syndrome could not be ruled out. 9,10 To the best of our knowledge, this is the first report describing the transfer of etizolam across the placenta. Further studies are needed to evaluate potentially harmful effects following exposure to etizolam in utero and during breastfeeding.…”

Epilepsy and pregnancy: What should the neurologists do?

“…The effect of fetal exposure to benzodiazepins is largely unknown. In the general population, use of benzodiazepine for anxiety during pregnancy is associated with preterm delivery and low birth weight and potential short-term neonatal effects of hypotonia, depression, and withdrawal [70]. A methodologically sound study found no greater risk for lower language competence at ages 3 years [71].…”

“…Concerning maternal epilepsy, there is an increased risk of neurodevelopmental disorders in pregnant women whose epilepsy is not optimally controlled, especially if the repeated seizures are generalized tonic-clonic [70].…”