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I am a neurologist who sub-specializes in epilepsy and often find myself considering this very question for women who begin having auras in their third trimester and are already on higher doses of their baseline antiepileptic medication that I do not want to increase further. The problem is that since there are not enough (practically any) good studies in pregnant women in the third trimester taking clonazepam, no one can really answer that question from an evidence-based perspective. So... no one will, because to give you a definitive answer sets the adviser up for a lawsuit if something goes wrong (I hate the truth of this reality, but it is). That being said, I would not suggest it in the 1st and 2nd trimester based on animal models which do show problems in the fetus, but by the third trimester, the baby is pretty much fully formed in a ways that clonazepam shouldn't really affect. BUT, given the dearth of good studies, I still tell my patients to use it as infrequently as possible and at as low a dose as possible, because the theoretical risk is still there. But if you have a seizure that makes you abort your child or prematurely deliver... then the judicious use of clonazepam was definitely the better option. What about anxiety? Unless my patient has severe anxiety as a psychiatric diagnosis, then I would probably just ask them to be anxious a little longer until delivery.

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