Johnny asked
I have a severe anxiety disorder that is controlled through medications. I am currently taking xanax, Lexapro, and Seroquel (the generic forms). It has taken years to find a combination of meds that works for me. I am wanting to become pregnant and I am concerned with controlling my anxiety and being safe for my child.
Answer
There are certainly options for you in terms of medicating while being pregnant. I first want to go over the pregnancy categories for the medications you are currently taking:
Xanax (Alprazolam)
Alprazolam is generally NOT recommended in pregnancy. It is listed as a risk category D medication. Positive evidence of human fetal risk exists based on investigational, marketing, or human studies, but the potential benefit to the mother may outweigh the potential risks to the fetus. In general, the use of benzodiazepines is not life-saving and thus should be avoided in pregnancy whenever possible. An increased risk of congenital malformations and other developmental abnormalities is associated with benzodiazepine use during the first trimester.
Lexapro (Escitalopram)
Escitalopram is classified in FDA pregnancy risk category C. According to the manufacturer, escitalopram should be used in pregnancy only when the benefits to the mother outweigh the potential risk to the fetus. There just is not enough data out there to give a good recommendation on way or the other.
Seroquel (Quetiapine)
Quetiapine is classified as FDA pregnancy category C. There are no adequate and well-controlled studies in pregnant women. However, when quetiapine was administered to rats or rabbits during the period of organogenesis, evidence of embryo/fetal toxicity was observed, including delays in skeletal ossification, minor soft tissue anomalies, and reduced body weight. In addition, maternal toxicity (decreases in body weight gain and/or death) was observed in these studies.
All in all, it is common for people to take SSRI drugs, such as Lexapro, during pregnancy. The selective serotonin reuptake inhibitors or SSRIs are the most frequently prescribed antidepressants in women who are pregnant. Although some studies of SSRI use in pregnancy show increased rates of low birth weight (less than 2500 grams or 5.5 pounds) and small for gestational age (birth weight less than 10% of age-adjusted weight), this finding is not consistent in all studies.Overall, it appears that antidepressant exposure may be associated with preterm birth, but the effects are small. The risks of antidepressant use should be weighed against the risks of untreated depression.
There are always treatment options for those who need it. I highly recommend asking your doctor for advice in this matter as they will have great experience dealing with situations like these.
Thank you and I hope my answer provided some assistance for you.
