Category Archives: Antidepressants

Interactions Between Antidepressants and Tamoxifen

Interactions Between Antidepressants and Tamoxifen

Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions with specific antidepressant medications (e.g., SSRI). These antidepressants are used widely to treat depression and anxiety disorders. In addition, multiple studies have shown that these antidepressants are an effective non-hormonal treatment for hot flashes; over [...]

Stress During Pregnancy Increases ADHD Risk

Stress During Pregnancy Increases ADHD Risk

While genetic factors are clearly important in determining a child’s risk for attention deficit hyperactivity disorder (ADHD), recent studies have investigated the link between exposure to certain maternal behaviors during pregnancy, such as smoking and alcohol use, and the risk of developing behavioral problems related to attention deficit hyperactivity disorder in childhood. While multiple studies [...]

New Study Does Not Find Link Between Paroxetine and Cardiovascular Defects

New Study Does Not Find Link Between Paroxetine and Cardiovascular Defects

In 2006, GlaxoSmithKline (GSK) elected to change product label warnings for the antidepressant paroxetine (Paxil), advising against the use of this drug by women who are pregnant. This decision was based on preliminary studies which suggested an increase in the risk of cardiovascular malformations among infants exposed to paroxetine in utero. A recent [...]

Research Study at CWMH: Bipolar Disorder in Pregnancy

Research Study at CWMH: Bipolar Disorder in Pregnancy

Are you an expectant mother? Do you have questions about bipolar disorder and antidepressants or mood-stabilizers during pregnancy? If you are pregnant and diagnosed with bipolar disorder (or manic depression), you may be eligible for this research study. Participants meet with research coordinators and psychiatrists who specialize in bipolar illness during pregnancy. For more information [...]

How to Treat Anxiety Symptoms During Pregnancy

How to Treat Anxiety Symptoms During Pregnancy

Given the limited information on the reproductive safety of certain medications, it is common for women to discontinue anti-anxiety medications during pregnancy. However, many women experience worsening of their anxiety symptoms during pregnancy, and it seems that the first trimester may be particularly difficult. Cognitive-behavioral therapy and relaxation techniques may be very useful for treating [...]

Cognitive Therapy versus Medication in the Treatment of Depression

Cognitive Therapy versus Medication in the Treatment of Depression

Both antidepressant medications and cognitive therapy have been shown to be effective for the treatment of depression; however, the question remains as to whether one treatment is preferred over the other. Subjects enrolled in The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (men and women with major depression, ages 18-75) were initially treated [...]

Paroxetine CR May Be Helpful for Menopausal Women Discontinuing Hormone Therapy

Paroxetine CR May Be Helpful for Menopausal Women Discontinuing Hormone Therapy

Estrogen was first approved by the FDA for the treatment of menopausal symptoms in 1942, and for many decades estrogen replacement therapy had been widely prescribed for peri- and post-menopausal women. In 2002, however, data from the Women’s Health Initiative (WHI) suggested that hormonal therapy may be associated with an increased risk of breast [...]

SSRIs and Pregnancy: Putting the Risks into Perspective

SSRIs and Pregnancy: Putting the Risks into Perspective

Depression is common during pregnancy, affecting 10% to 15% of women. While psychotherapy is an attractive option for the treatment of depression during pregnancy, all women do not respond to this intervention and many require pharmacotherapy. Thus far, no antidepressants have yet been approved by the FDA for use during pregnancy. Although data accumulated over [...]

Antidepressant-Induced Sexual Side Effects

Antidepressant-Induced Sexual Side Effects

A recent article published in Psychiatric Times reviews options for the management of antidepressant-induced sexual dysfunction. According to this review, sexual side effects may occur in 40% to 70% of patients treated with serotonin reuptake inhibitors (SRIs) and is a common reason for poor compliance with treatment and eventual discontinuation. When sexual side effects occur, [...]

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Use of Wellbutrin (Bupropion) During Pregnancy

Use of Wellbutrin (Bupropion) During Pregnancy

There are data to support the use of certain antidepressants during pregnancy. Most of the research over the last decade has focused on the selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and the older tricyclic antidepressants, but there is some new data supporting the use of bupropion during pregnancy.
The most recent information from the [...]

Evaluating the Long-Term Effects of Prenatal Antidepressant Exposure

Evaluating the Long-Term Effects of Prenatal Antidepressant Exposure

Over the last decade information has accumulated regarding the safety of antidepressants taken during pregnancy. While much research has addressed the effect of antidepressant drugs on risk for congenital malformation, less research has focused on the long-term effects of prenatal antidepressant exposure.
In a landmark study from Irena Nulman and her colleagues at the Mortherisk program [...]

Withdrawal Symptoms in Newborns Exposed to SSRIs

Withdrawal Symptoms in Newborns Exposed to SSRIs

A recent report suggests that newborns exposed to selective serotonin reuptake inhibitors (SSRI) antidepressants such as Prozac, Zoloft, Celexa and Paxil may be at risk for developing withdrawal symptoms after delivery (Levinson-Castiel 2005). However, the investigators also noted that the symptoms usually disappeared within 48 hours and did not require medical intervention.
In this study, published [...]

SSRIs and Persistent Pulmonary Hypertension of the Newborn

SSRIs and Persistent Pulmonary Hypertension of the Newborn

Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for “toxicity” in newborns exposed to [...]

Relapse of Major Depression during Pregnancy

Relapse of Major Depression during Pregnancy

Over the last decade, the number of reproductive-age women treated for depression has increased significantly. Given the incomplete information available regarding the reproductive safety of many antidepressant medications, many women choose to discontinue pharmacologic treatment during pregnancy. However, several studies estimate that about 10 to 15% of women suffer from depression during pregnancy (O’Hara et [...]

SSRIs and Neonatal Outcomes: A Population-Based Study from Finland

SSRIs and Neonatal Outcomes: A Population-Based Study from Finland

Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for “toxicity” in newborns exposed to [...]

Neonatal Symptoms After In Utero Exposure to SSRIs

Neonatal Symptoms After In Utero Exposure to SSRIs

The increasing number of reproductive-age women taking antidepressants has raised concerns about the potential risks of using these medications during pregnancy. Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to [...]

Should SSRIs Be Discontinued Prior to Delivery?

Should SSRIs Be Discontinued Prior to Delivery?

About 10-15% of women suffer from depression during pregnancy. The rates are probably even higher among those women who have histories of depression prior to pregnancy. Thus, many women with recurrent illness make the decision to remain on antidepressant during pregnancy. While there have been many studies supporting the reproductive safety of certain antidepressants, including [...]

Paroxetine and Cognitive-Behavioral Therapy (CBT) for the Treatment of Postpartum Depression

Paroxetine and Cognitive-Behavioral Therapy (CBT) for the Treatment of Postpartum Depression

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Non-pharmacologic interventions, including interpersonal psychotherapy, have been shown to be effective for the treatment of PPD. In addition, several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) and the serotonin norepinephrine reuptake inhibitor venlafaxine (Effexor). In [...]

Infertility Treatment: A Trigger for Depression and Anxiety

Infertility Treatment: A Trigger for Depression and Anxiety

While several studies have demonstrated high levels of psychological distress among women pursuing infertility treatment, few studies have assessed the prevalence of psychiatric illness in populations undergoing infertility treatment using standardized diagnostic instruments. In a recent study from Taipei Veterans General Hospital, a university-affiliated medical center in Taiwan, women attending an assisted reproduction clinic were [...]

Long-term Effects of Fetal Exposure to Antidepressants

Long-term Effects of Fetal Exposure to Antidepressants

Although data accumulated over the last 30 years suggest that some medications may be used safely during pregnancy, our knowledge regarding the risks of prenatal exposure to psychotropic medications is incomplete. Because neuronal migration and differentiation occur throughout pregnancy and into the early years of life, the central nervous system (CNS) remains particularly vulnerable to [...]

Bupropion and Breastfeeding

Bupropion and Breastfeeding

Data have accumulated over the last few years on the use of antidepressants in nursing mothers. It appears that all antidepressants are secreted into the breast milk; however, the amount of medication [...]

Venlafaxine for Postpartum Depression

Venlafaxine for Postpartum Depression

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) sertraline, fluoxetine, and fluvoxamine for the treatment of this disorder. In a recent report, Cohen and colleagues have demonstrated the efficacy of venlafaxine for the treatment of [...]

Breastfeeding and antidepressants

Breastfeeding and antidepressants

When discussing the use of antidepressant medications by breastfeeding women, It is somewhat misleading to say that certain medications are “safer” than others. All medications taken by the mother are [...]

Selecting an Antidepressant During Pregnancy

Selecting an Antidepressant During Pregnancy

Most women and their doctors try to avoid using medications during pregnancy. Of greatest concern is that a medication used during pregnancy may in some way harm the developing fetus or, at the [...]

Intermittent Dosing of SSRIs for PMS

Intermittent Dosing of SSRIs for PMS

Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression [...]