With the rush of everyday life, psychotropic medications are increasingly needed to help with anxiety and also with modern diseases such as panic disorder1 or anxiety disorder2, for example. One of these medications is Rivotril (Clonazepam), which is a controlled and extremely addictive medication. Does Rivotril use during pregnancy cause problems? Is it recommended to use this drug during pregnancy? How do you know if the benefit is greater than the risk?
What is Rivotril? Rivotril, whether during pregnancy or not, is a medication based on benzodiazepine. It has calming, anticonvulsant, tranquilizing, muscle relaxant, and sedative properties3. Basically, it inhibits the central nervous system. First, to use this type of medication, it is necessary for a doctor to prescribe it and control its use, since it is a black-label drug. Since the formulation of Rivotril is addictive, with just 15 days of continuous use, a person is already prone to become dependent. Some psychiatrists recommend its use for extreme conditions or problems, but Rivotril during pregnancy is extremely controlled.
Many women who use this medication may have to stop it when they become pregnant. At least in the first trimester, doctors advise against using Rivotril during pregnancy because it poses a risk of malformation to the baby. Most psychiatrists trust the use of this medication during the second trimester of pregnancy, but gynecologists ask that it be used only in urgent situations and emergencies during a crisis, in case the woman has problems and was treated before pregnancy. It is noted that Rivotril passes in small amounts through the placenta; however, since it causes dependence, it is better that it be used sporadically. In extreme situations, obstetricians themselves may recommend the use of this medication, but only after the first trimester of pregnancy, that is, 12 weeks.
However, there is controversy regarding use prior to pregnancy. This medication should not be stopped abruptly. It is better for the reduction to be done gradually and proportionally. If the patient takes 1mg per day, it is recommended to reduce to 0.5. From there, lower to 0.25 until stopping completely. This will result in fewer side effects and avoid withdrawal crises. Some women may continue with low doses during pregnancy, as some doctors allow it because they believe there are no major problems.
Risk vs. Benefits of Rivotril During Pregnancy
To determine the risk vs. benefit of Rivotril during pregnancy, the doctor will assess the patient’s situation and determine if there is any risk greater than the potential benefit during pregnancy. If the woman suffers from depression and needs the medication, the best option is to assess each case individually to decide whether to allow its use. That’s why it’s important for the pregnant woman to talk to her doctor as soon as she finds out she is pregnant. If discontinuation is recommended, the doctor may advise the patient to resume use after a safe period during pregnancy. Some doctors believe the problems caused by the patient’s condition are much worse, so they allow use even before the end of the first trimester. As mentioned, it’s all about cost–benefit, and it depends on the situation.
The problem with psychotropic drugs is the late-onset side effects. Use of Rivotril during pregnancy, for example, can cause attention deficit in children whose mothers used sedatives. These women, who use sedatives like clonazepam or diazepam, for instance, have a higher chance of postpartum depression. Furthermore, the use of benzodiazepine-based medications is not recommended during breastfeeding, as they can be secreted in breast milk.
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Additionally, other ways to relieve the symptoms of Rivotril withdrawal during pregnancy can be used, such as massages, physical activity, meditation, yoga, and also water aerobics. These activities increase serotonin levels, which will provide a sense of well-being and alleviate symptoms that indicate the use of controlled medications. Still in doubt? Consult your doctor. No one is better than your doctor to explain what using Rivotril during pregnancy can do. Remember that each case is different and yours may not be severe enough to make the use of this type of medication beneficial.
See also: Medications in Pregnancy – Use with Safety!
Photo: drw25, Kanko
