In this essay published in the Journal of the American Medical Association, Dr. Helen Kim (an alumna of the CWMH) discusses the challenges of treating women with severe psychiatric illness during pregnancy: “Would a physician tell a pregnant woman with epilepsy, ‘Stop your meds and ride out the seizures until you  deliver’? Are the medications [...]

Antenatal exposure to Wellbutrin (bupropion) does not appear to be associated with an increased risk of malformations in the exposed infant; however,  it is not known if exposure to Wellbutrin during pregnancy has any effect on the child’s neurobehavioral development. In a study from Figueroa and colleagues published in 2010, insurance claims data from 38,704 [...]

Clinically significant anxiety symptoms are common during the postpartum period and frequently complicate the treatment of postpartum depression.   While SSRIs are indicted for the treatment anxiety symptoms, especially when they co-occur with depression, many women may need to use a benzodiazepine for managing more severe symptoms of anxiety or insomnia.  An early study from Birnbaum [...]

While a handful of studies have assessed the risk for congenital malformations in infants exposed to antipsychotic agents, there is even less information regarding neonatal outcome in this population.  In 1992, it was first reported that infants exposed to first-generation antipsychotic medications exhibited increased muscle tone, tremulousness, and poor motor functioning when assessed within a [...]

The North American Menopause Society (NAMS) has updated its 2010 recommendations regarding the use of postmenopausal hormone therapy (HT) based on evidence accumulated subsequent to the previous report.  In the decade since the first publication of the results from the Women’s Health Initiative, we have accumulated evidence to indicate that multiple factors influence the effects [...]

At MGH, we have Rounds weekly.  For 2-3 hours per week, we discuss clinical cases, papers that come out in our field, and discuss our research.  We have a relatively large group of perinatal psychiatrists, all of whom do clinical work, as well as social workers and a psychologist who regularly join us.  This past [...]

Since starting this website 8 years ago, the number of articles relevant to the field of reproductive psychiatry has increased dramatically.   In the beginning, there were one or two articles published each month that merited a more thorough review.  Things have certainly changed.   While we would like to review all of the relevant articles in [...]

A few years ago on our blog, we reviewed a paper suggesting that estrogen may be a beneficial treatment for women with schizophrenia.  In this study patients with schizophrenia receiving estrogen showed significant improvement in their positive symptoms (hallucinations, delusions), but no difference in negative symptoms (reduction in range of emotional expression, poverty of speech, [...]

We want to thank those of you who have continued to subscribe to our blog and who have visited our website. Some have written noting particular interest in the research conducted at the MGH Center for Women’s Mental Health, including the National Pregnancy Registry for Atypical Antipsychotics. The purpose of the National Pregnancy Registry for Atypical [...]

Topiramate (marketed as a Topamax), in addition to its use for the treatment of epilepsy, is now being prescribed to reproductive aged women for a broad spectrum of indications, including migraine headaches, weight control, and mood stabilization.  Limited information is available on its reproductive safety; however, the preliminary data we do have raises some concerns [...]

A few weeks after the FDA called into question the association between SSRI exposure and persistent pulmonary hypertension of the newborn or PPHN, BMJ published another article supporting an increased risk of PPHN among infants exposed to SSRIs in utero. This large study is similar to the studies published by Kallen and colleagues using the [...]

Sources of vitamin D include sunlight (ultraviolet B, or UVB, rays), dietary intake, and supplements.  Sunlight is the main source of human vitamin D.  Vitamin D refers to different forms of a steroid hormone.   Vitamin D3 (also called 1, 25-dihydroxycholecalciferol or calcitriol) is produced by the body when ultraviolet light (in the form of UV [...]

In 2006, Chambers and colleagues published an article in the New England Journal of Medicine linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN).   Based on these findings, the “Usage in Pregnancy” section on the labels for SRRI antidepressants was updated to include the following warning: “Infants exposed [...]