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If I take Xanax while pregnant, how much of the medication crosses over to the placenta?

I know that most doctors recommend not taking anything (especially during the first trimester). I, however, have extreme GAD and anxiety attacks and can not live a normal life without taking my low dose of xanax (.25 mg per day). I have tried other medications, exercise, meditation, and therapy. The panic attacks still occur. My question is with such a low dose, how much of it crosses over to the placenta? I have talked to my OBGYN and she does not recommend it, but my psychiatrist understands. I have read a lot of scholarly articles about this subject and I feel like it would be in my and my future baby's best interest to continue to take a low dosage of xanax.
This is an important question to discuss with your OBGYN. Xanax (alprazolam) is a pregnancy category D medication. Pregnancy category D means that there have been studies done on the medication in pregnancy and have found adverse (negative) effects on the fetus. This means that in general, most physicians would not recommend you use that medication. Most physicians would therefore not write the scrip while you are pregnant. My practice is to not prescribe category D medications while someone is pregnant unless the health of the mother is in danger. So the question is whether or not your treating physicians feel that your anxiety and panic attacks are so severe that the risks of adverse effects on the fetus outweigh the benefits. The best physician for you to discuss this with is your OBGYN who has the most experience (likely much more than your psychiatrist) in pregnant women and what medications are the most risky. One alternative would be to switch from Xanax to another medication such as an SSRI. SSRIs are category C and therefore not really recommended either, but are in general safer in pregnancy than category D medications. SSRIs work better than Xanax for anxiety and panic attacks and this is why I never prescribe Xanax over an SSRI under any circumstance. In the end, you and your doctors will have to make a decision weighing both the risks to your health and that of your baby's. Good luck.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
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