If a doctor recommends medication for prenatal anxiety, there are several options they may prescribe. Uncontrolled ongoing anxiety during pregnancy, also known as antenatal anxiety, can affect both the parents and the baby. However, the right treatment can help control pregnancy anxiety.
Many people worry that anxiety can harm their baby. However, the tools, resources, and support a person needs to manage symptoms are widely available, and there are many options to suit an individual’s needs.
This article looks at anxiety medications that are safe for pregnant women. It also discusses other ways to manage symptoms, such as therapy and natural remedies.
Which Anxiety Medications Are Safe?
If a doctor prescribes medication for prenatal anxiety, there are several options they may recommend. Although all medications have risks, doctors aim to prescribe the safest medication at the lowest effective dose.
There are medications that doctors use to treat anxiety that they also prescribe to treat depression. Antidepressants that health care professionals may prescribe during pregnancy include:
- Some selective serotonin reuptake inhibitors (SSRIs): A large study found no association between sertraline (Zoloft), one of the most prescribed SSRIs, and birth defects. Although they found that paroxetine (Paxil) and fluoxetine (Prozac) have some association with some birth defects, it’s important to note that the risk of these conditions is still incredibly low.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs also offer a relatively low-risk option for pregnant women with anxiety. Examples of this type of medication include duloxetine (Cymbalta) and venlafaxine (Effexor XR).
- Other medications: If SSRIs or SNRIs aren’t effective, doctors may prescribe other medications. Individuals can discuss the risks of each with a doctor before taking them.
Doctors sometimes prescribe benzodiazepines to treat severe anxiety. A 2019 meta-analysis found that these drugs may be associated with an increased risk of certain birth defects. However, further research is needed to investigate these findings. It’s also important to note that exposure to benzodiazepines during pregnancy is rare, and people taking them should talk to a healthcare professional if they have concerns.
Potential Risks of Medication
Although some studies show a link between anxiety medication use and preterm birth, low birth weight, and birth defects, there is also a risk of untreated mental health conditions. Untreated prenatal anxiety can contribute to miscarriage, preterm birth, and birth complications.
There are also risks associated with discontinuing SSRI and SNRI medications, especially in the short term. Since these medications can cause unpleasant withdrawal symptoms, a person needs to wean them off gradually under a doctor’s supervision.
Stopping medication “cold turkey” or deciding to stop medication before a person is ready can cause their mental health to deteriorate.
There are many ways a person can manage their anxiety symptoms. These may include the help of a health care professional, such as a physician or psychologist, or individuals may make other lifestyle or lifestyle changes on their own.
Therapy is an important treatment for anxiety. Some forms of therapy may be more effective than others for managing anxiety symptoms, while individuals respond differently to different types.
The following self-care tips may also be helpful:
- Reduce sources of stress: For example, one can try to schedule their daily activities on an hourly basis. It makes a stressful day feel more manageable, while studies show it can help treat symptoms of anxiety and depression.
- Follow a nutritious diet: Try to eat a balanced diet. A person may also want to limit caffeine and sugar intake, which can make anxiety worse.
- Exercise regularly: Research shows that physical activity can reduce anxiety.
- Get enough sleep: Try to go to bed and wake up at consistent times. Use relaxation techniques, such as guided breathing, to help reduce anxiety before bedtime.
- Perform relaxation techniques: Perform deep breathing, progressive muscle relaxation, and grounding techniques.
- Participate in activities: Try to incorporate pleasant activities into your day, such as calling a friend or reading a book.
- Start journaling: Writing can help reduce anxiety and uncover triggers for people’s fears and anxiety. Bringing a journal into therapy can also be helpful.
- Self-empowerment: This can help reduce a person’s anxiety – often, learning more about a situation is empowering, and this can reduce symptoms.
While these tips may help some people, they are general tips. Individuals who believe they have anxiety should talk to a doctor and seek guidance on self-care strategies before starting anything new.
Can Pregnancy Worsen Anxiety?
Yes, pregnancy can trigger or worsen anxiety. Some research suggests that anxiety disorders are among the most common types of psychiatric disorders during and after pregnancy, affecting 11-17% of pregnant women.
It is important to note that this study, along with most research in this area, examined cisgender women. There is limited research on the mental health implications of pregnancy for trans and non-binary people. A 2020 review suggests that these groups may be more vulnerable to mental health problems during and after pregnancy. The authors of the review called for more research in the field. Additionally, it is important to note that this review looked at studies involving predominantly white individuals.
Pregnancy and childbirth cause many changes, including hormonal effects, some of which include anxiety and fear. A 2016 review of studies suggests that the following factors can increase a person’s risk of developing prenatal anxiety:
- lack of partner support
- history of abuse or domestic violence
- unplanned or unwanted pregnancy
- prior mental illness
- pregnancy loss
- adverse events in life and high perceived stress
- lack of social support
- present or past pregnancy complications
Anxiety during pregnancy can be mild or severe, and symptoms can get better or worse as the pregnancy progresses. Depression and anxiety also often co-occur, with 30-58 percent of pregnant women experiencing both.
Although anxiety is common during and after pregnancy, treatment can benefit pregnant women. Many medications can help, and therapy is another effective option, especially for mild to moderate anxiety. Other coping strategies, such as mindfulness and self-care, can also help people manage their anxiety symptoms.
Those experiencing prenatal anxiety may need to talk to a doctor or mental health professional who can provide appropriate support and treatment.