Effects of chlordiazepoxide (Librium) during pregnancy and lactation

The decision to use psychotropic drugs during pregnancy and lactation must depend upon considerations of teratogenicity, effects on fetal and neonatal behavior and development, and a concern for the health and safety of the mother. Pregnancy itself can exacerbate anxiety symptoms, as well as alter the pharmacokinetics of antianxiety drugs; it thus presents a special problem to the clinician treating anxiety disorder in women. Since almost all psychotropic drugs cross the placenta, the use of medications during pregnancy and lactation requires critical attention to the timing of exposure, dosage, duration of use, and fetal susceptibility. Risk to the mother and fetus can be reduced with a number of simple strategies, including monotherapy with the lowest effective, multiple dose of a drug for the shortest period necessary and avoidance of exposure to Benzodiazepines (BZDs) during the first trimester, since this is when the developing fetus is most vulnerable to the toxic effects of most agents. This literature review highlights information from various sources regarding risks for pregnant and lactating mothers to long acting BZDs, especially Chlordiazepoxide.