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Ativan use in pregnancy
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Ativan use in pregnancy

Dr.,
I am 7 weeks pregnant. I have one 8 yr.old son and am 36 yrs. old. I have been on Lexpro and ativan for several years. My ob/gyn told me to stop the ativan, but my Psychiatrist told me that the ativan was fine and it was better for me not have panic attacks. I'm trying to find specific statistics, linking ativan to abnormalities.... 1 in 100 births, 1 in 4000 etc.
Can you help me please?

Michelle Holloway
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You should follow the advice of your doctor and if they disagree, you should have them talk to each other:

This is from Reprotox:
"LORAZEPAM
Quick take: Experimental animal studies do not suggest that clinical use of lorazepam increases the risk of congenital malformations. Administration near delivery may cause floppiness in the infant."

This is from Teris:

"Agent Name: LORAZEPAM Review Date: 05/08

Summary of Teratology Studies:

Lorazepam is a benzodiazepine that is used orally to treat anxiety and parenterally as an antiemetic and anticonvulsant.

=========================
MAGNITUDE OF TERATOGENIC
RISK TO CHILD BORN AFTER
EXPOSURE DURING GESTATION
=========================

UNDETERMINED

===============================
QUALITY AND QUANTITY OF DATA
ON WHICH RISK ESTIMATE IS BASED
===============================

LIMITED

========
COMMENTS
========

NONE

An association with maternal use of lorazepam was observed among infants with anal atresia in a study of 262 children with congenital anomalies whose mothers took a benzodiazepine during the first trimester of pregnancy (Bonnot et al., 2001). The interpretation of a particular drug-malformation association within this group of children who all had congenital anomalies and whose mothers all took a benzodiazepine during pregnancy is uncertain.

The frequency of malformations was not increased among the offspring of pregnant mice or rats treated orally with 2-20 times the human dose of lorazepam (Esaki et al., 1975). In another study, no "gross dysmorphism" was seen, but decreased weight and increased activity were observed among the offspring of mice treated with 10 times the maximum human dose of lorazepam during pregnancy (Chesley et al., 1991). Cleft palate occurred with increased frequency among the offspring of mice injected with 400 times the maximum human parenteral dose of lorazepam during pregnancy (Jurand & Martin, 1994). Increased frequencies of cleft palate and open eyelid are also said to have occurred among the offspring of pregnant rats treated with 90-100 times the maximum oral dose of lorazepam (Mehrannia et al., 2003). "Anomalies," presumably of the fetus, are said to have occurred at various doses in these unpublished rabbit studies. Behavioral alterations were observed among adult offspring of rats treated throughout pregnancy with lorazepam in a dose about 5 times the maximum used in humans (Livezey & Smith, 1994).

Neonatal hypotonia and feeding difficulties have been reported in infants born of women treated with lorazepam late in pregnancy, either chronically or just during labor (Whitelaw et al., 1981; McAuley et al., 1982; Sanchis et al., 1991). In one study, maternal intravenous lorazepam treatment for hypertension was associated with low Apgar scores, hypothermia, poor feeding, and need for assisted ventilation in the neonates (Whitelaw et al., 1981). Preterm infants appear to be especially susceptible to these adverse effects of lorazepam. Long-term effects of prenatal lorazepam exposure have not been studied. "

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