Trying to conceive, pregnancy, and postpartum can be seriously trying times. For some, it even results in loss of sleep, trying to combat that perinatal anxiety that shows up in the middle of the night just when your body needs more rest than ever.
Sometimes, people turn to a type of depressants that cause sedation called benzodiazepines, including brand-name drugs like xanax, ativan, or valium, to help with insomnia issues. But, a recent study showed that this can result in a significant increase in miscarriage risk for the fetus (1). The study noted that almost 2 percent of women are currently prescribed this medication in their first trimester. The study out of Taiwan was published in late December in the Journal of the American Medical Association Psychiatry, and noted the concerning potential of these drugs.
The risk was not small. The study, which included over 3 million pregnancies from nearly 2 million women showed an increased risk of around 70 percent. Dr. Timothy Jeider, Psychiatrist at Nevada Mental Health, says this study comes after other previous studies have also linked this type of medication to negative outcomes in pregnancy, “which is why it is not recommended to be used during pregnancy.” He says it is uncommon to prescribe these types of pills in pregnancy, though there are still some reasons to use them in pregnancy — a conversation each doctor and patient need to have together to evaluate risk.
“Many people suffering from anxiety have difficulty sleeping. Because benzodiazepines relieve anxiety and as a side effect can make a person sleepy. Thus, some providers have gotten into the habit of prescribing benzos for sleep. Part of the reason they get prescribed so often is pressure can come from patients who take benzodiazepines feel like they are finally able to sleep when they otherwise were not able to,” Jeider says. “But this is not a good idea.”
He explains that people can become tolerant to the anti-anxiety and sleep-inducing effects of benzos relatively easily. “This means they need more and more medication to get the same effect. Eventually, they would need potentially lethal doses of a benzo to get the same effect.”
He has additional concerns with this type of drug, saying that they distort a person’s “sleep architecture.”
“We need quality sleep to feel rested. When a person sleeps due to a benzo, they feel like they are sleeping, but the quality of sleep is quite poor and not very restorative. This decreased quality is hard to appreciate in the short run, but takes its toll in the long run.” And any pregnant person knows that they need real sleep more than anything in those tough nine months.
In addition, these medications have a “significant” risk for abuse, Jeider says, and can lead to addiction. There are safer options, he says.
“Qualified physicians know: benzos are bad for babies. Use in extreme circumstances only.” He recommends pregnant women talk to a board-certified physician for better options, and to ensure their insomnia, anxiety, and other sleep and mental health issues are properly handled in a safe way for the mom and baby.
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Sources
1. Meng L, Lin C, Chuang H, Chen L, Hsiao F. Benzodiazepine Use During Pregnancy and Risk of Miscarriage. JAMA Psychiatry. Published online December 27, 2023. doi:10.1001/jamapsychiatry.2023.4912
Jeider, Timothy. Author interview. January 2024.
