Bipolar disorder (types I and II) affect up to 5% of the population in the United States. As the onset of this condition typically occurs during or before the reproductive years, the management of bipolar disorder in women is often complicated by pregnancy. There are concerns regarding fetal exposure to medication, the impact of untreated [...]

After last week’s post, we received several comments regarding the use of mood stabilizers in breastfeeding women, specifically asking which is safer: lithium or lamotrigine. Based on the available data, it is difficult to say with certainty which is “safer”.  To date, there has been one report of an adverse event in a nursing infant [...]

Women with bipolar disorder are vulnerable to postpartum illness, and it is generally recommended that mothers continue treatment with a mood stabilizer throughout the postpartum period to reduce their risk of relapse; however, this recommendation is complicated by the all mood stabilizers are secreted into the breast milk, although their concentrations appear to vary considerably [...]

Atypical antipsychotics are increasingly used to treat psychiatric disorders such as bipolar disorder or schizophrenia.  In spite of the important role they play for many patients in treating serious psychiatric disorders, atypicals have been associated with negative side effects that may worsen a patient’s cardiovascular health profile.  This includes a greater risk for weight gain, [...]

Happy holidays from the Center for Women’s Mental Health! As we finish up 2008, we thank you for your support and interest in our program over the past year. The following are the ten most widely read posts from our blog over the past six months: 1. Use of Wellbutrin (Bupropion) During Pregnancy – February [...]

The U.S. Food and Drug Administration (FDA) has proposed major revisions to prescription drug labeling in order to provide more accurate and helpful information on the effects of medications used during pregnancy and breastfeeding. As it stands, the current system used by the FDA classifies the reproductive safety of medications using five risk categories (A, [...]

Approximately 25% of American women of reproductive age smoke tobacco, and many continue to smoke during and after pregnancy despite the known potential harm to their own health and to their child’s health. These health threats remain after the child’s birth as the baby is exposed to nicotine and other toxins in both ambient air [...]

All medications are secreted into the breast milk, although concentrations appear to vary. There is a fair amount of information on the use of Paxil (paroxetine) in nursing women. While Paxil may be detected in the breast milk, there have been no reports of adverse events in the nursing infant. The only situation where one [...]

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 with [...]

Because rates of postpartum illness are very high in women with bipolar disorder, it is generally recommended that mothers continue treatment with a mood stabilizer throughout the postpartum period to reduce their risk of relapse; however, the use of medications during the postpartum period is complicated by the issue of breastfeeding. All medications are secreted [...]

It is clear that women with bipolar disorder are at high risk for relapse during the immediate postpartum period (Viguera 2000). There is evidence that the resumption of lithium prior to or within 24-48 hours of delivery can significantly reduce the risk of postpartum illness (Cohen 1995). While this intervention is the current standard of [...]

Postpartum depression is a relatively common event, affecting 10 to 15% of women after the birth of a child. Many women, however, do not receive treatment, and one of the most common reasons for avoiding or deferring treatment is concern regarding the use of medications while breastfeeding. A preliminary study from Lee and colleagues at [...]

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 to which the nursing child is exposed appears to be relatively small. We have the most information is available for fluoxetine (Prozac), sertraline [...]

Over the years, various studies have demonstrated the many advantages of breastfeeding, findings that have led the American Academy of Pediatrics to recommend that all mothers breastfeed their children for the first year of the child’s life. Several studies have also examined the relationship between breastfeeding and intellectual development in younger children and have demonstrated [...]