*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
It is unclear if Xanax is safe to take while pregnant, but some patients taking Xanax while pregnant may be advised to continue taking it, despite potential risks. There is a risk of fetal harm, displaying sedation, or neonatal withdrawal when born to parents who were taking Xanax through pregnancy.
It is important to discuss whether Xanax is the best fit for you while pregnant with a prescriber. If you want to discuss your current prescription with a provider or are considering a prescription for Xanax, online psychiatry platforms such as Talkiatry are a good place to start. Talkiatry is one platform that can and will prescribe benzodiazepines, which are controlled substances. They offer assessments and can help you determine the best medication options while pregnant or breastfeeding.
Boxed Warning: Risks of Alprazolam (Xanax) include misuse, addiction, withdrawal and even death
Alprazolam, the active ingredient in Xanax, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA).
- Taking Xanax, a benzodiazepine, with other opioid medications increases your risk for serious side effects that include severe sedation, slower breathing, coma, and death. Xanax should not be taken with an opioid unless there are no other options.
- Taking Xanax can lead to misuse (abuse) and addiction of the medication, which can increase your risk of overdose and death.
- Using Xanax can lead to physical dependence and this risk increases the longer you take Xanax. If you suddenly stop taking Xanax, you can experience withdrawal. Withdrawal can be life threatening. Xanax should only be discontinued by gradual tapering of the dose.
Xanax is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
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What Is Xanax (Alprazolam) & How Does it Work?
Xanax, with the active ingredient alprazolam, is FDA-approved for the acute treatment of generalized anxiety disorder in adults and the treatment of panic disorder, with or without agoraphobia, in adults. FDA approval means a medication has been found to be safe and effective for a specific use based on data from clinical trials. Xanax also comes as an extended-release formulation known as Xanax XR, and it is only FDA-approved to treat panic disorder, with or without agoraphobia. Both Xanax and Xanax XR are available as generic alprazolam.
Xanax may also be prescribed off-label for conditions including insomnia, depression, and premenstrual dysphoric disorder (PMDD). Off-label use means a medication is not specifically FDA-approved to treat a certain condition. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Xanax is a benzodiazepine that is thought to work by increasing the activity of a natural chemical in the brain called GABA, resulting in a calming or relaxing effect.1
Side Effects of Xanax
Xanax, like all medications, may cause side effects for some who take it. Xanax’s side effects are due to how it works on the central nervous system, the body’s processing center that controls most of the body’s core functions, such as movement, breathing, and heart rate. Side effects associated with Xanax include impairment of your bodily functions, decreased alertness, as well as a change in your blood pressure and libido.
Xanax may make you feel temporary effects as your body adjusts to the medication. These effects should go away with consistent usage of the medication. It’s also possible that side effects may continue throughout your Xanax treatment. Some side effects are mild, but severe side effects may require medical attention as they can be life-threatening. If you have questions about potential side effects, contact your doctor or pharmacist.
Common Xanax side effects include*:1, 2
- Impaired coordination
- Low blood pressure
- Slurred speech
- Changes in libido
- Dry mouth
- Drowsiness
- Tiredness
- Dizziness
- Memory problems
- Constipation
- Nausea
- Headache
Serious side effects of Xanax that may require immediate medical attention include*:1
- Seizures
- Breathing difficulty
- Excessive sleepiness
- Coma
- Psychosis
- Delirium
- Jaundice
- Withdrawal
- Confusion
- Worsening depression
- Increased suicidal ideation
Xanax’s effects on motor skills and drowsiness are some of the most noticeable side effects when treating anxiety symptoms and panic attacks. If your symptoms worsen over time, seek immediate medical care.
*All medications, including Xanax, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Is Xanax Safe During Pregnancy?
Currently, there is no association between Xanax and birth defects, but it is unclear if it is safe for use during pregnancy as the medication was not studied in pregnant patients.1 Prior to labeling changes by the FDA, Xanax was listed as a pregnancy category D drug which means that there is a risk for fetal harm.3 It has been reported that the newborns of parents who use medications like Xanax late in pregnancy may display symptoms of sedation or withdrawal. However, the potential benefits of taking Xanax may still outweigh the risks, as untreated anxiety during pregnancy can also be harmful.
If you are pregnant or may become pregnant, it’s important to talk with your healthcare provider about the potential risks and benefits of taking or stopping Xanax.
Online Psychiatry
Circle Medical – Anxiety and Depression Treatment. Meet with an online doctor today! All prescriptions are based on necessity determined by a medical professional. Diagnosis and prescription over video. Insurance accepted. No membership or hidden fees. Same day appointments. Visit Circle Medical
Plushcare There are many effective medications for anxiety and depression, including Zoloft and Lexapro, which a Plushcare doctor can prescribe. In as little as 15 minutes, you can speak with a board-certified doctor from PlushCare to receive anxiety or depression treatment. Plushcare DOES NOT prescribe controlled substances. Visit Plushcare
Can Xanax Cause Birth Defects?
According to data from published observational studies, Xanax does not have a clear association with major birth defects. The background risk, which is risk that cannot be avoided, of major birth defects and miscarriage for pregnant patients on benzodiazepines is currently unknown. Although early studies reported an increased risk of congenital malformations with other benzodiazepines, no consistent pattern was noted. Overall, more studies need to be done to confirm if Xanax increases the likelihood of birth defects.1
Can Xanax Cause Withdrawal Symptoms in Your Baby?
Xanax withdrawal may occur in newborns when a pregnant patient takes Xanax. This may occur during pregnancy and up to the time of birth or throughout breastfeeding. When a pregnant patient on Xanax gives birth, the newborn will be watched for any signs of withdrawal. Symptoms of withdrawal in infants include poor feeding, over-responsive body reflexes, irritability, restlessness, and inconsolable crying.1
Can Taking Xanax Cause Preterm Birth or Low Birth Weight?
Some studies suggest Xanax may increase the chance of low birth weight and preterm birth. However, not all studies found this association. According to one study, there was a higher chance of a baby being admitted to the neonatal intensive care unit (NICU) if they were exposed to benzodiazepines.4
Does Xanax Affect Fertility or Increase the Chance of Birth Defects When Taken by Male Patients?
A small study looked at the effects of Xanax and other psychiatric medications on semen. It found that it decreased the movement of sperm compared to those who were not on psychiatric medications. Pending a larger study to confirm this finding, the study concludes that the decreased movement and concentration of sperm could potentially make it harder for conception to occur.4
What Xanax Dosage Is Safe During Pregnancy?
If you are pregnant and it was determined that the benefits outweigh the risks for you to continue Xanax, then your doctor will create a treatment plan for you with these factors in mind. As with any condition, the aim is to have the lowest effective Xanax dose to manage your condition. If you have concerns about your Xanax dosage, consult your doctor since dosage can vary from person to person.
What If You Are Already Taking Xanax When You Become Pregnant?
If you are already taking Xanax when you become pregnant, then immediately contact your doctor to discuss your options. Depending on your condition and how well it is managed, your doctor will help you arrive at a decision that is best for you. Some patients will be recommended to stop taking Xanax under doctor supervision, while others may be advised to stay on Xanax due to the benefits outweighing the potential risks.
Should You Stop Taking Xanax If You Think You Might Be Pregnant?
You should never stop taking Xanax without consulting a doctor first. There is a potential for withdrawal if you do not stop Xanax correctly, which can lead to uncomfortable and even life-threatening symptoms. If you suspect you are pregnant and you are on Xanax, your doctor can help you determine your best course of action.
Can You Breastfeed While on Xanax?
There is limited data on Xanax in breast milk, but there have been reports of side effects in infants who were exposed to medications like Xanax through breast milk. It was reported that these infants experienced sedation, poor feeding, and poor weight gain. The full effects of Xanax on lactation are unknown. Due to the potential for serious side effects, such as sedation and withdrawal symptoms in infants, patients are generally recommended not to breastfeed while on Xanax.1
Xanax Alternatives During Pregnancy
There are alternatives to Xanax for treating anxiety disorders. Some patients are recommended to switch to a non-benzodiazepine medication, such as SSRIs and SNRIs, to help manage their anxiety symptoms. Other than prescription medication, helpful methods to help with anxiety are lifestyle changes as well as behavioral therapy.
Xanax alternatives during pregnancy may include non-benzodiazepine medications as well as natural, behavioral, or non-prescription treatments.
Which anxiety medications can help you feel better?
There are many effective medications for anxiety including Zoloft and Lexapro, which a Plushcare doctor can prescribe. In as little as 15 minutes, you can speak with a board-certified doctor from PlushCare to receive anxiety treatment.
Plushcare DOES NOT prescribe controlled substances, including XANAX.
Non-benzodiazepine Medications
Antidepressants are a common choice to help manage mood disorders such as anxiety and panic disorders. SSRIs and SNRIs are typically the first choice of antidepressants as they have fewer side effects than older antidepressants. This may also be beneficial for patients who may have other mood disorders other than anxiety, such as depression.
There may still be risks associated with taking antidepressants during pregnancy. Currently, there is no evidence that prenatal exposure to these medications may cause congenital malformation.5 Treatment looks different from person to person, so it is best to discuss your options with a trusted doctor.
Non-prescription Alternatives to Xanax
Therapy may be an effective option for managing anxiety symptoms and helping patients develop coping skills. Therapy is often recommended alongside medication treatment for anxiety. Cognitive behavioral therapy (CBT) is one such therapy that can help patients with a skills-focused treatment that aims to alter harmful emotional responses by changing their thoughts and behaviors.
Practicing mindfulness for anxiety may also help symptoms. Mindfulness techniques help people to become aware of thoughts and emotions in the present moment without interpreting them. It may help relax the body and mind to reduce stress. Some may also use supplements, such as magnesium and other herbals, although more research is needed before these remedies can be recommended to patients.6
Lifestyle Habits That Help Manage Anxiety Symptoms
Lifestyle habits may impact your mental health since your physical health can impact your mental health. Managing your diet and sleep may help your anxiety symptoms, reduce stress, and increase your energy. The mental health benefits of exercise and quality sleep can be significant. Other impactful lifestyle changes may help patients manage anxiety symptoms, such as eating healthy and regular meals, staying hydrated, and participating in relaxing activities.
Questions to Ask Your Healthcare Provider About Xanax & Pregnancy
You may have many questions about taking Xanax while pregnant and the potential harms and benefits for you and your unborn baby. To determine the best treatment, talk with your doctor or psychiatrist about your treatment plan. If needed, online psychiatry services are an option if you cannot attend an in-person appointment or need to switch doctors.
Questions to ask your care team when considering using Xanax while pregnant may include:
- Do my symptoms warrant anxiety and panic disorder medication?
- I’m already on an anxiety and panic disorder medication; should I switch to another one?
- Which medication do you suggest, and how did you reach that conclusion?
- What doses are considered safe?
- Should I take this medication throughout my pregnancy or only for parts?
- Does this medication affect the baby? How?
- What happens if I decide to stop taking this medication?
- Can I continue this medication if I choose to breastfeed?
- Will this medication help with postpartum depression?
- What is the risk of medications for anxiety or depression while pregnant versus the risk of not taking any medication?
In My Experience
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
Online Psychiatry
Circle Medical Anxiety and Depression Treatment. Meet with an online doctor today! All prescriptions are based on necessity determined by a medical professional. Diagnosis and prescription over video. Insurance accepted. No membership or hidden fees. Same day appointments. Visit Circle Medical
Plushcare There are many effective medications for anxiety and depression, including Zoloft and Lexapro, which a Plushcare doctor can prescribe. In as little as 15 minutes, you can speak with a board-certified doctor from PlushCare to receive anxiety or depression treatment. Plushcare DOES NOT prescribe controlled substances. Visit Plushcare
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A few questions from Talkiatry can help you understand your symptoms and give you a recommendation for what to do next.
Best Online Psychiatry Services
Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.