A number of drugs have embryotoxic and teratogenic effects, which can result in negative consequences for both the health of the child and the mother. The consequences of taking medicines depend not only on the type of drug, the dose, and duration of therapy but also on the duration of pregnancy.
There are three critical periods of embryogenesis when the effect of adverse factors is the most dangerous. The first critical period of embryogenesis occurs at the beginning of the second week of pregnancy, when cell differentiation occurs, their regenerative capacity decreases and sensitivity to medicinal substances increases as well. After implantation, the organogenesis period begins, which lasts until the 3rd-4th month of intrauterine life. During this period, the most sensitive to the action of drugs is the 3rd-8th week (the second critical period of embryogenesis). The third critical period of embryogenesis occurs in the 18th-22nd week. During this period, the most significant changes occur in the bioelectrical activity of the brain, hemopoiesis, and production of hormones.
Most psychotropic drugs, including Ativan and other medicines available in pharmacies, are biologically active substances and can have an undesirable effect on the fetus during the mother’s pregnancy. In addition, psychotropic drugs and their active metabolites easily penetrate into the milk of the nursing mother and affect the newborn, causing sedation, suppression of the CNS, respiration, circulation.
Benzodiazepines are able to penetrate the placenta and accumulate in the fetal tissues. The toxic effect of benzodiazepines on the central nervous system is caused by their slow metabolism in the fetus. There are reports that the continued use of benzodiazepines can cause congenital anomalies and malformations, although this possibility has not been fully proven. Long-term use of benzodiazepines during the last 3 months of pregnancy can lead to the development of a “withdrawal syndrome” in the fetus. Usually only one prescription of benzodiazepines is allowed in case of severe toxicosis of pregnancy, eclampsia or during anesthesia of childbirth. Benzodiazepines penetrate the mammary glands, milk of the mother, and can have an undesirable effect on the newborn, leading to a disorder of the respiratory and circulatory systems.
In view of the foregoing, the use of psychotropic drugs during pregnancy and lactation should be strictly limited. Psychotropic drugs should be prescribed only when the need for their use exceeds the potential risk of adverse effects on the fetus. In any case, you should avoid taking psychotropic drugs during critical periods of pregnancy, when the laying of organs of the unborn child takes place (4-10th week of pregnancy). If in such situation taking psychotropic drugs is necessary, they should be prescribed for a short period, at lower doses, with a temporary cancellation for 5-10 days before the day of birth.