TABLE 2

Maternal Nonnarcotic Drugs That Cause Neonatal Psychomotor Behavior Consistent With Withdrawal

DrugSignsOnset of SignsDuration of SignsaRef. 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 
DrugSignsOnset of SignsDuration of SignsaRef. 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 
a

Prescription indicates the infant was treated with pharmacologic agents, and the natural course of the signs may have been shortened.

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