Complications & Concerns Anxiety After Miscarriage and Medication Safety During Pregnancy By Krissi Danielsson Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. Learn about our editorial process Updated on January 12, 2022 Medically reviewed by Carly Snyder, MD Medically reviewed by Carly Snyder, MD Facebook LinkedIn Twitter Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments. Learn about our Medical Review Board Print GaryPhoto / Getty Images Table of Contents View All Table of Contents Benzodiazepines Selective Serotonin Reuptake Inhibitors Tricyclic Antidepressants The Decision That's Right For You It is not uncommon for women (and sometimes men) to develop an anxiety disorder after a miscarriage. But is it safe for women to use anxiety drugs to control the symptoms in a subsequent pregnancy? Why Anxiety Is Common After Miscarriage and How to Cope Feelings of anxiety after a miscarriage might be specific to anxiety about a new pregnancy or could be anxiety about life in general. Some may face the choice of whether to use anti-anxiety medications to control anxiety following a miscarriage. For couples who want to try for a new pregnancy, this begs the question of whether or not these drugs are safe in a subsequent pregnancy. Unfortunately, the research is conflicting about the safety of psychiatric medications during pregnancy, and the answer isn't always clear. Here's what we know about specific drug categories: Benzodiazepines Currently, most doctors do not recommend using this class of drugs during pregnancy. Benzodiazepines, such as Valium and Xanax, have been linked by some reports to an increased risk of orofacial clefts, hypotonia, apnea, and feeding difficulties in infants. Other studies have found no risk of using benzodiazepines during pregnancy, so the matter is still up for debate. Some doctors will still prescribe benzodiazepines during pregnancy in cases where they feel the benefits outweigh the possible risks. Selective Serotonin Reuptake Inhibitors (SSRIs) Drugs in the category, such as Prozac (fluoxetine), are technically considered antidepressants. But, research suggests they can also help with anxiety. Researchers disagree about the safety of SSRI use during pregnancy; some studies have found no long-term effects, but others have found evidence of possible neonatal problems for babies exposed to SSRIs during pregnancy. Currently, the American College of Obstetricians and Gynecologists recommends that decisions about using SSRIs during pregnancy be made on an individual basis but advises against the use of Paxil during pregnancy, when possible. Tricyclic Antidepressants (TCAs) Some research has also found TCAs, such as Tofranil (imipramine), to be helpful for anxiety as well as depression. Several studies have looked at the use of tricyclics during pregnancy, and none have found conclusive evidence of long-term problems. One 2007 study, however, did find evidence that using tricyclics or SSRIs during the third trimester increased the risk of preterm delivery and complications for the baby at birth. Make the Decision That's Right For You Many women prefer to avoid drugs entirely during pregnancy, but research is showing that having uncontrolled severe anxiety during pregnancy might cause problems for the baby, too. So, it definitely becomes a question of weighing the risks and benefits. Some women prefer to seek out cognitive-behavioral therapy or other non-drug anxiety treatments instead of (or before trying) pharmaceuticals. In any case, the choice of whether or not to use anxiety medication during pregnancy is up to you and your doctor. If you are suffering from severe anxiety after a miscarriage, this is an important discussion to have. Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American College of Obstetricians and Gynecologists, "ACOG Issues Opinion on SSRI Antidepressant Use During Pregnancy." 1 Dec 2006. Browers, Evelien, Anneloes Van Baar, Victor J.M. Pop, "Maternal Anxiety During Pregnancy and Subsequent Infant Development." Infant Behavior & Development 2001. Chambers, Christina D., Sonia Hernandez-Diaz, Linda J. Van Marter, Martha M. Werler, Carol Louik, Kenneth Lyons Jones, and Allen A. Mitchell, "Selective Serotonin-Reuptake Inhibitors and Risk of Persistent Pulmonary Hypertension of the Newborn." New England Journal of Medicine 9 Feb 2006. Chokroverty, Sudhansu, "Patient Information: Insomnia." UpToDate for Patients 15 Jan 2008. Davis, Robert L., David Rubanowice, Heather McPhillips, Marsha A. Raebel,Susan E. Andrade, David Smith, Marianne Ulcickas Yood, Richard Plat, "Risks of Congenital Malformations and Perinatal Events Among Infants Exposed to Antidepressant Medications During Pregnancy." Pharmacoepidemiology and Drug Safety Aug 2007. Kulin, Nathalie A., Anne Pastuszak, Suzanne R. Sage, Betsy Schick-Boschetto, Glenda Spivey, Marcia Feldkamp, Kelly Ormond, Doreen Matsui, Amy K. Stein-Schechman, Lola Cook, Joanne Brochu, Michael Rieder, and Gideon Koren, Pregnancy Outcome Following Maternal Use of the New Selective Serotonin Reuptake Inhibitors." JAMA Feb 1998. Ormond, Kelly, and Eugene Pergament, "Update: Benzodiazepines in Pregnancy." Illinois Teratogen Information Service. Ward, Randy K. and Mark A. Zamorski, "Benefits and Risks of Psychiatric Medications During Pregnancy - Practical Therapeutics." American Family Physician 15 Aug 2002. By Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit