Xanax (Alprazolam) & Pregnancy | Benefits & Risks

Many people take alprazolam (brand name Xanax) to treat symptoms of anxiety or panic disorder. 

Like all prescription medications, Xanax can cause side effects. It also poses a risk of abuse and addiction. That’s why some people hesitate to use it, especially pregnant women who worry not only about their own health but also about the health of their baby. 

According to obstetricians and other medical professionals, using Xanax while pregnant comes with both benefits and risks. 

Benefits Of Taking Xanax While Pregnant

When you’re pregnant, hormonal changes and the stress of planning for a new baby can cause serious anxiety. 

This anxiety may be even more severe if you already have an anxiety disorder. 

An untreated anxiety disorder during pregnancy can lead to behaviors that harm you and your baby. These behaviors might include:

• missed doctor’s appointments
• poor eating habits
• alcohol or drug consumption 

These behaviors can cause issues like low birth weight and premature birth. Thus, using Xanax to treat anxiety could benefit your pregnancy in some cases. 

Risks Of Taking Xanax While Pregnant

The United States Food and Drug Administration (FDA) classifies Xanax as a Category D pregnancy drug. 

This means that while the drug’s benefits might outweigh its risks for some pregnancies, the medication may also lead to: 

• birth defects
• floppy infant syndrome
• neonatal abstinence syndrome (NAS)

Birth Defects

If you take Xanax during your first trimester (the first three months of pregnancy), your baby may face an increased risk of cleft lip (a split in the upper lip) and/or cleft palate (a split in the roof of the mouth).

These birth defects can be treated with surgery, speech therapy, and dental care. 

Floppy Infant Syndrome

If you take Xanax during your second or third trimester (months four to nine of you pregnancy), your baby may develop floppy infant syndrome.

Also called hypotonia, floppy infant syndrome causes a baby to have a low muscle tone. The child may feel limp or ragdoll-like when held and might have trouble holding their head up. 

Seek medical advice right away if you think your baby may have this condition. Most babies will require physical therapy, sensory stimulation, and other forms of care to recover.

Neonatal Abstinence Syndrome (NAS)

Taking Xanax late in your pregnancy can also lead to a withdrawal syndrome called neonatal abstinence syndrome (NAS). 

Simply put, because your baby was exposed to Xanax while in the womb, they may experience postpartum withdrawal symptoms such as:

• trouble sleeping
• trouble feeding
• trouble gaining weight
• rapid breathing
• blotchy skin coloring 
• sweating
• fever
• irritability
• excessive or high-pitched crying
• sneezing and stuffy nose
• diarrhea 
• vomiting
• trembling
• seizures

If you notice these or other unusual symptoms, contact your baby’s health care provider immediately. Your child may need to stay in the hospital for a few weeks or months to recover from NAS.

Once your baby leaves the hospital, their doctor may recommend taking steps to further ease NAS symptoms, such as:

• gentle rocking 
• skin-to-skin contact
• decreasing harsh lights and noises
• breastfeeding (though your doctor may advise against this if you’re still using Xanax, as the drug can pass into breast milk and cause side effects in your baby)

Alternatives To Xanax During Pregnancy

If you’re concerned about the above risks but still want to treat your anxiety while pregnant, talk to your doctor about creating a treatment plan that doesn’t include Xanax. 

Your plan may include strategies like:

• cognitive behavioral therapy, where you’ll learn to identify unhealthy thinking patterns and adopt healthy behaviors
• antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), which can reduce anxiety while posing less of a threat to your baby
• natural mood-boosting activities like exercise, massage therapy, and yoga

Learn more about Xanax Alternatives

Note that you shouldn’t quit Xanax cold turkey while pregnant. You may experience withdrawal symptoms that could harm your baby, especially if you abused Xanax or took it for a long time. 

To avoid or decrease withdrawal symptoms, talk to your doctor about gradually tapering off Xanax instead. Depending on your situation, you may need to attend a medical detox program where you can safely withdraw from Xanax under medical supervision. 

If you or someone you love is abusing or addicted to Xanax, please reach out to an Ark Behavioral Health specialist to learn about our detoxification and substance abuse treatment programs.