Expert: Lawrence Jay Rappaport <B>M.D.</B> Date: 2/16/2004 Subject: taking ativan before realizing pregnant
Question hello Dr. Rappaport,
I am 25 years old and I have no children my last menstrual period was around mid January. I am very concerned because I have become unexpectedly pregnant. I was prescribed Ativan (Lorazepam) 1mg whenever I felt restless and needed sleep. Therefor I may have taken as many as 15 as few as 4 or 5. I am almost 100% positive of the day I became pregnant which would be only 3 weeks ago so it is probably more like 5 pills. But just in case consider it was 15 as well. Even though this is a very unplanned pregnancy we would like to have the baby. How much damage may I have done? What about the ativan that has been in my system. I am very scared I may have done some horrible damage to my baby. Please help.
Sincerely,
Danielle Marchant
Answer It is hard to say of the Ativan caused damage to the fetus or not. Reproduction studies have been conducted in animals. Occasional, non-dose related malformations (reduction of tarsals, tibia, metatarsals, malrotated limbs, gastroschises, malformed skull, and microphthalmia) were observed in rabbits, but these defects have also randomly occurred in controls. Fetal resorption and increased fetal loss occurred in rabbits. Lorazepam crosses the placenta, achieving cord levels similar to maternal serum concentrations. Placental transfer is slower than that of valium but high doses may cause the "floppy infant" syndrome. A higher incidence of respiratory depression occurred in newborn infants exposed to Ativan. I doubt that the amount of Ativan that you ingested caused any harm to the fetus at this stage in your pregnancy, but I would advise you not to continue its use for the remainder of the pregnancy.
