Maternal Nonnarcotic Drugs That Cause Neonatal Psychomotor Behavior Consistent With Withdrawal
| Drug . | Signs . | Onset of Signs . | Duration of Signsa . | Ref. No. . |
|---|---|---|---|---|
| Alcohol | Hyperactivity, crying, irritability, poor suck, tremors, seizures; onset of signs at birth, poor sleeping pattern, hyperphagia, diaphoresis | 3–12 h | 18 mo | 14,15 |
| Barbiturates | Irritability, severe tremors, hyperacusis, excessive crying, vasomotor instability, diarrhea, restlessness, increased tone, hyperphagia, vomiting, disturbed sleep; onset first 24 h of life or as late as 10–14 d of age | 1–14 d | 4-6 mo with prescription | 12,13 |
| Caffeine | Jitteriness, vomiting, bradycardia, tachypnea | At birth | 1-7 d | 161 |
| Chlordiazepoxide | Irritability, tremors; signs may start at 21 d | Days–weeks | 9 mo; 11/2 mo with prescription | 11 |
| Clomipramine | Hypothermia, cyanosis, tremors; onset 12 h of age | 4 d with prescription | 162 | |
| Diazepam | Hypotonia, poor suck, hypothermia, apnea, hypertonia, hyperreflexia, tremors, vomiting, hyperactivity, tachypnea (mother receiving multiple drug therapy) | Hours–weeks | 8 mo; 10–66 d with prescription | 10 |
| Ethchlorvynol | Lethargy, jitteriness, hyperphagia, irritability, poor suck, hypotonia (mother receiving multiple drug therapy) | Possibly 10 d with prescription | 163 | |
| Glutethimide | Increased tone, tremors, opisthotonos, high-pitched cry, hyperactivity, irritability, colic | 6 mo | 164 | |
| Hydroxyzine | Tremors, irritability, hyperactivity, jitteriness, shrill cry, myoclonic jerks, hypotonia, increased respiratory and heart rates, feeding problems, clonic movements (mother receiving multiple drug therapy) | 5 wk with prescription | 58 | |
| Meprobamate | Irritability, tremors, poor sleep patterns, abdominal pain | 9 mo; 3 mo with prescription | 165 | |
| SSRIs | Crying, irritability, tremors, poor suck, feeding difficulty, hypertonia, tachypnea, sleep disturbance, hypoglycemia, seizures | Hours–days | 1–4 wk | 31–33,35 |
| Drug . | Signs . | Onset of Signs . | Duration of Signsa . | Ref. No. . |
|---|---|---|---|---|
| Alcohol | Hyperactivity, crying, irritability, poor suck, tremors, seizures; onset of signs at birth, poor sleeping pattern, hyperphagia, diaphoresis | 3–12 h | 18 mo | 14,15 |
| Barbiturates | Irritability, severe tremors, hyperacusis, excessive crying, vasomotor instability, diarrhea, restlessness, increased tone, hyperphagia, vomiting, disturbed sleep; onset first 24 h of life or as late as 10–14 d of age | 1–14 d | 4-6 mo with prescription | 12,13 |
| Caffeine | Jitteriness, vomiting, bradycardia, tachypnea | At birth | 1-7 d | 161 |
| Chlordiazepoxide | Irritability, tremors; signs may start at 21 d | Days–weeks | 9 mo; 11/2 mo with prescription | 11 |
| Clomipramine | Hypothermia, cyanosis, tremors; onset 12 h of age | 4 d with prescription | 162 | |
| Diazepam | Hypotonia, poor suck, hypothermia, apnea, hypertonia, hyperreflexia, tremors, vomiting, hyperactivity, tachypnea (mother receiving multiple drug therapy) | Hours–weeks | 8 mo; 10–66 d with prescription | 10 |
| Ethchlorvynol | Lethargy, jitteriness, hyperphagia, irritability, poor suck, hypotonia (mother receiving multiple drug therapy) | Possibly 10 d with prescription | 163 | |
| Glutethimide | Increased tone, tremors, opisthotonos, high-pitched cry, hyperactivity, irritability, colic | 6 mo | 164 | |
| Hydroxyzine | Tremors, irritability, hyperactivity, jitteriness, shrill cry, myoclonic jerks, hypotonia, increased respiratory and heart rates, feeding problems, clonic movements (mother receiving multiple drug therapy) | 5 wk with prescription | 58 | |
| Meprobamate | Irritability, tremors, poor sleep patterns, abdominal pain | 9 mo; 3 mo with prescription | 165 | |
| SSRIs | Crying, irritability, tremors, poor suck, feeding difficulty, hypertonia, tachypnea, sleep disturbance, hypoglycemia, seizures | Hours–days | 1–4 wk | 31–33,35 |
Prescription indicates the infant was treated with pharmacologic agents, and the natural course of the signs may have been shortened.