We previously reported that paroxetine, a selective serotonin reuptake inhibitor (SSRI), may affect sperm motility and may thus have a negative impact on male fertility. Many women who are planning a pregnancy question whether SSRIs and other antidepressants may affect fertility; this is obviously a particularly important issue for those who are having difficulty conceiving. [...]
Tag Archives: Anxiety
Generalized Anxiety in Pregnancy
Few studies have focused on anxiety disorders in the perinatal period. While various studies have measured levels of anxiety or distress during pregnancy, most studies have relied upon self-report questionnaires to assess for anxiety. In contrast, few studies have used standardized diagnostic criteria to determine the prevalence of anxiety disorders in pregnant populations. In a [...]
Anxiety During Pregnancy: How Does it Affect the Developing Fetal Brain?
During fetal life, neurons proliferate, migrate and form connections, providing the structure of the developing brain. Neurons reach their final destinations by the 16th week of gestation, while branching and making appropriate connections occur even before that time (1). The brain continues to develop during the entire pregnancy, with most of the synapse formation in [...]
Anxiety During Pregnancy Predicts Worse Outcomes
In treating pregnant women with mood or anxiety disorders, we tend to focus primarily on the reproductive safety of psychotropic medications; however, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may carry some degree of risk. Untreated psychiatric illness in the mother cannot be considered a benign [...]
Depression and Anxiety: Do They Impact Infertility Treatment?
Infertility affects an estimated 10-15% of couples of reproductive age. Several studies have indicated that patients undergoing in vitro fertilization (IVF) experience high levels of stress, depression, and anxiety. Multiple risk factors for anxiety and depression during infertility treatment have been identified; these include being female, age over 30, lower level of education, lack of [...]
Panic Disorder Increases the Risk of Adverse Birth Outcomes
Anxiety often results in the activation of the sympathetic nervous system. This activation is commonly known as the “fight or flight response”; symptoms may include increased heart rate, shortness of breath, perspiration, chest pain, and nausea or diarrhea. Activation of the fight or flight response is also associated with the activation of numerous other responses [...]
Using New Research to Inform Treatment Decisions during Pregnancy: A Case Report
As more research is conducted within the field of women’s mental health, there are times when recommendations may change depending on the available data. We will discuss a case here to illustrate this point. The patient is a 32 year old woman with a history of anxiety who was first evaluated by this clinician in [...]
Top 10 Blog Posts from the MGH Center for Women’s Mental Health
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 [...]
Identifying Postpartum Depression: A Three Question Screening Tool
While postpartum depression is common among new mothers, our ability to reliably detect this illness remains poor. Recent studies have indicated that most obstetricians report that they screen for postpartum psychiatric problems at routine follow-up visits but typically do not use standardized instruments to assess for postpartum depression. Unfortunately, studies which have measured the success [...]
Impact of Infertility Treatment on Risk for Depression and Anxiety
Infertility and its treatment have been shown to be a trigger for both depression and anxiety. Women with pre-existing histories of depression and anxiety who have been stable on medication may find themselves with worsening symptoms brought on by the stress involved in the process of infertility treatment. Many women find the process an emotional [...]
Maternal Stress and Low Birth Weight Predict Later Risk for Mood and Anxiety Disorders
It has been postulated that psychological stress in the mother, if present at a critical time of brain development, can permanently alter a child’s response to stress and may have long-term negative consequences. In response to stress, blood flow to the uterus is restricted and the fetus receives fewer nutrients, which may result in lower [...]
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 [...]
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 [...]
Link Found Between Anxiety and Preterm Birth
While there have been concerns regarding the reproductive safety of psychotropic medications, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may not always be the safest option. Untreated psychiatric illness in the mother cannot be considered a benign event, and a number of studies have indicated that [...]
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
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 [...]
Depression and Preterm Labor
Although most people tend to think of pregnancy as a time of emotional well-being, depression is relatively common, affecting about 1 in 10 women. While there are obvious concerns related to the use of antidepressants during pregnancy and the effects of these medications on the developing fetus, less attention has focused on the impact of [...]
Benzodiazepines and Pregnancy
The data regarding the use of the benzodiazepines (including Klonopin, Xanax, Ativan, and Valium) during pregnancy are somewhat controversial. Studies suggest there may be an increased risk of cleft lip and palate associated with first trimester exposure to these medications. This risk appears to be relatively small. Early reports suggest that the risk is about [...]
Serzone for Panic Disorder During Pregnancy
It is relatively common for women with panic disorder to experience recurrent anxiety and panic symptoms during pregnancy. This is especially true for women who have been stabilized on an anti-panic medication prior to conception and abruptly discontinue the medication after becoming pregnant. For women who would like to avoid the use of medications during [...]

