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Mental Health  (Expert Forum)
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Clonazepam, pregnancy and insomnia
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.

Clonazepam, pregnancy and insomnia

by slambie, Feb 28, 2005 12:00AM
Hello,



I am 31 years old and for the past three years, I have taken .5 mgs of clonazepam and 10 mgs of Lexapro nightly in order to sleep. While I don't think I suffer from chronic depression, panic attacks or abnormal anxiety, this seems to be the only combination of medications (aside from heavy-duty rx sleeping pills) that enable me to sleep. My psychiatrist and I came upon this combination after more than 10 years of working with doctors and specialists to help me with this insomnia, which has plagued me since I was a teen. I believe it's hereditary -- I had a grandmother who also suffered from a life long of severe insomnia which eventually resulted in her taking her own life in her late 50s. At any rate, I am currently 25 weeks pregnant. I discontinued both the klonopin and Lexapro the moment I suspected I was pregnant, so at most, the embreo was exposed to it for the first 2 weeks after conception. A recent sonogram suggests that the baby is doing fine and does not have a cleft pallet.



While I managed to get a fair amount of sleep during the first 16 weeks of pregnancy, I have been now suffering from what I would call extreme insomnia for the last 9 weeks: like 1 - 2 hours a night. I've been taking 10 mgs of Ambien 2-3 nights a week for the last 3 weeks and can usually get 4-6 hours of sleep on it, but I'm afraid to take it more often then that.



My qestion is this? Would it be safe to resume the clonazepam and lexapro now that I'm in my 25th week? If not, is there a safer alternative that would help? And if not, how often can I take Ambien and what are the risks associated with it?



Thanks in advance for your help!

SBL

by Roger Gould, M.D., Mar 01, 2005 12:00AM
Hello, I would like to help you...this is an important issue and deserves a better answer than I am capable of giving you. There are so many studies on this subject and only someone who has a special interest can digest them and give you the best advice.  I suggest two other sources.  Through your psychiatrist, ask him or her to talk to a university trained psychopharmacologist to get the latest information.  Also, ask your obstetrician or pediatrician.  Either should be able to give you a good solid answer.
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