Is alprazolam safe during pregnancy?
Answered by MotherToBaby’s teratology specialists, quoted in full — including the questions most pages skip, like whether a father’s exposure matters.
The questions people actually ask about alprazolam in pregnancy
Answered by MotherToBaby, the fact sheets written by the Organization of Teratology Information Specialists and published through the NIH. Quoted in full — we do not condense them.
I take alprazolam. Can it make it harder for me to get pregnant?
It is not known if alprazolam can make it harder to get pregnant.
Does taking alprazolam increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. It is unlikely that alprazolam would greatly increase the chance of miscarriage.
Does taking alprazolam increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect.
Most studies on alprazolam use in the first trimester have not reported an increased chance of birth defects. Two reports that looked at prescription records reported a higher chance for heart defects if a prescription for alprazolam was filled during pregnancy. Studies based on prescription records cannot tell if a person took the medication, so it is hard to know if the outcomes are related to the medication or other factors. Overall, an increased chance of birth defects has not been proven.
Does taking alprazolam in pregnancy increase the chance of other pregnancy-related problems?
Some studies have suggested that alprazolam might increase the chance of preterm delivery (birth before week 37) and low birth weight (less than 5 pounds, 8 ounces [2500g] at birth). Other studies have not found this association.
I need to take alprazolam throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
The use of benzodiazepines (including alprazolam) during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal and can include trouble regulating body temperature, trouble breathing, low energy, poor feeding, and vomiting. Most often, symptoms start soon after birth and could last several days. Not all babies exposed to alprazolam will have symptoms. It is important that your healthcare providers know you are taking alprazolam so that if symptoms occur your baby can get the care that is best for them.
Does taking alprazolam in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if alprazolam can cause behavior or learning issues for the child.
If a man takes alprazolam, could it affect fertility (ability to get a woman pregnant) or increase the chance of birth defects?
There is 1 report of a man who had delayed ejaculation and impotence (trouble with getting and keeping an erection) while taking alprazolam. One small study found lower sperm motility (movement) in those taking psychotropic medications (including alprazolam) compared to men who did not take psychotropic medications. These issues might make it harder to conceive a pregnancy. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/
Quoted from MotherToBaby Fact Sheets — Alprazolam, published August 2024. MotherToBaby states its fact sheets should not take the place of medical care and advice from your healthcare providers.
Breastfeeding is a separate question — what LactMed says about alprazolam
This is general reference information, not medical advice. Whether to take any medication in pregnancy is a decision for you and your prescriber; do not start or stop a drug on your own, because an untreated condition can also carry risk.