QUESTION:
Dear Dr. Heller,
I am a therapist who primarily works with borderlines. I have a client who wants to get pregnant and remain on Xanax PRN, or go on BuSpar. What are you feelings about safety of this? Would it be possible to have her come off Risperdal slowly and hope the BuSpar handles her anxiety. Her last child she had while taking Risperdal and there were complications. I would appreciate your input and will definitely be purchasing your book. Thanks.
ANSWER:
BuSpar is now a class 2 medication regarding pregnancy. This means it's
considered safe in pregnancy with the understanding that no medications have been studied
adequately to know for sure.
I'm not aware of any studies on Xanax, but since maternal use of addicting drugs causes
drug dependence in the child, I'd be concerned about it's use. This is particularly
true based on the 1988 study showing Xanax worsens behavioral dyscontrol for those with
the BPD. It comes down to a risks v benefits issue, as all medication decisions do
whether during pregnancy or not.
I'd be concerned about Risperdal considering the number of brain systems it works on.