It is relatively common for women with panic disorder to experience recurrent anxiety and panic symptoms during pregnancy. This is especially true for women who have been stabilized on an anti-panic medication prior to conception and abruptly discontinue the medication after becoming pregnant. For women who would like to avoid the use of medications during pregnancy, cognitive-behavioral therapy may be very useful for reducing symptoms and eliminating the need for medication.
However, some women with severe panic symptoms during pregnancy may require medication. While there are data to support the reproductive safety of certain antidepressants during pregnancy, not all medications have been well characterized. Unfortunately, there is very little information on the use of Serzone (nefazodone) during pregnancy. It is for this reason that we try to avoid this medication during pregnancy and use other medications that have been studied more extensively. Prozac (fluoxetine) and the tricyclic antidepressants are useful for the treatment of panic disorder and their reproductive safety has been well studied; research indicates that there is no increase in risk of congenital malformation in infants exposed to these medications in utero. Nor is there any consistent evidence that these medications are associated with any serious complications during pregnancy.
Ruta Nonacs, MD PhD
