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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Panic Attacks?

I m on 4mg of klonopin a day and I just found out I m pregnant. I suffer from severe panic attacks and I m also on bupropion 150mg and and 100mg of sertraline for to help with both depression and anxiety. I have cut down on the klonopin to 2mg but I m scared it will harm the baby. I m only about three weeks along. Is there any options to look at as far as replacing the klonopin to something safer? Thank you do much!!! Ivy
Thu, 24 Jul 2014
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Psychiatrist 's  Response
Hello, thanks for the query. I admit that your concerns about the baby are indeed well informed. Clonazepam (Klonopin) is a benzodizepine which is known to cause conditions like cleft palate in baby. Similarly though very low but sertraline can also cause some problems in baby like pulomnary hypertension. Though data on bupropion is not definitve; but all in all its safe to avoid all of these 3 drugs during pregnancy. Also bupropion exacerbates anxiety symptom & may not be a good option for your problem. Hence, you can switch to less riskier options like escitalopram which are relatively safer for your baby & you can consult a Psychologist to learn autogenic relaxation exercises, cognitive behaviour therapy (CBT), exposure & response prevention rituals (ERP), deep breathing exercises which are tad slow but proven to improve anxiety & panic attacks. Lastly, do try yoga, pranayam & 30 minute daily physical exercise in addition to all these. You can revert back to me for further help. Good luck
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What Causes Severe Panic Attacks?

Hello, thanks for the query. I admit that your concerns about the baby are indeed well informed. Clonazepam (Klonopin) is a benzodizepine which is known to cause conditions like cleft palate in baby. Similarly though very low but sertraline can also cause some problems in baby like pulomnary hypertension. Though data on bupropion is not definitve; but all in all its safe to avoid all of these 3 drugs during pregnancy. Also bupropion exacerbates anxiety symptom & may not be a good option for your problem. Hence, you can switch to less riskier options like escitalopram which are relatively safer for your baby & you can consult a Psychologist to learn autogenic relaxation exercises, cognitive behaviour therapy (CBT), exposure & response prevention rituals (ERP), deep breathing exercises which are tad slow but proven to improve anxiety & panic attacks. Lastly, do try yoga, pranayam & 30 minute daily physical exercise in addition to all these. You can revert back to me for further help. Good luck