Depression during pregnancy is relatively common, affecting about 10 to 15% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, many women and their physicians would prefer to avoid the use of these medications during pregnancy; thus, there is a clear need for effective non-pharmacologic treatments for [...]
Tag Archives: Pregnancy
Intrauterine Cannabis Exposure Affects Fetal Growth
January 21, 2010 – 12:46 pm
Although the risks of smoking tobacco while pregnant are well documented and well publicized to the general population, women continue to smoke cigarettes during pregnancy. Smoking cigarettes is known to increase a woman’s risk of having a low-birth weight baby and increases the risk of preterm delivery. While clinicians often ask about and discourage tobacco [...]
Use of the Emsam Patch (Selegiline) in Pregnancy
December 14, 2009 – 10:56 am
A clinician asks: “Is there any data on the use of the Emsam patch in pregnancy?”
There is very little information on the reproductive safety of the MAOI-B inhibitor, selegiline, which is the active ingredient of the Emsam patch. While animal studies have failed to reveal any evidence of teratogenicity, the medical literature includes [...]
Panic Disorder Increases the Risk of Adverse Birth Outcomes
December 8, 2009 – 10:11 am
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 [...]
SSRIs and PPHN: A Review of the Data
November 10, 2009 – 11:57 am
In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Since that time, several other reports have been published which have examined the association between SSRI antidepressants and PPHN. Here is a summary of the findings to date:
Chambers et [...]
Lamotrigine and Pregnancy: An Update
August 25, 2009 – 1:30 pm
While anticonvulsants, such as lamotrigine (Lamictal), topiramate (Topamax), and gabapentin (Neurontin), are being used with increasing regularity for the treatment of women with bipolar disorder, we have limited information with respect to the reproductive safety of the newer anticonvulsant agents. In 2006, we reported on preliminary data indicating an increased risk of oral clefts among [...]
What Would You Do? A Pregnant Women on Duloxetine (Cymbalta)
June 29, 2009 – 1:25 pm
Ms. A is a 27-year-old woman who is seven weeks pregnant and is currently taking duloxetine (Cymbalta). She has a history of recurrent major depressive disorder (MDD) and has had a good response to duloxetine at 60 mg per day. She has had four previous episodes of major depressive disorder (most untreated) and has been [...]
Do SSRIs Increase the Risk of Preeclampsia?
June 22, 2009 – 12:03 pm
Hypertension in pregnancy is generally defined as a diastolic blood pressure of 90 mm Hg or greater or a systolic pressure at or above 140 mm Hg. Preeclampsia is defined as the development of hypertension with proteinuria or edema induced by pregnancy, generally in the second half of gestation. It is more common in women [...]
OCD in Pregnant and Postpartum Women
June 18, 2009 – 9:44 am
The lifetime prevalence rate of obsessive-compulsive disorder (OCD) has been consistently estimated to be 2%-3% in the general adult population throughout the world, making OCD one of more common psychiatric diagnoses; however research on OCD in pregnancy and peurperium has been limited.
Although most studies have not been designed to estimate the prevalence of pregnancy-related OCD [...]
Maternal Depression During Pregnancy May Lead to Infant Sleep Problems
May 12, 2009 – 9:42 am
About 15% of women suffer from depression during pregnancy, and many reports have suggested that depression during pregnancy may have negative effects on the fetus. A new study from researchers at the University of Michigan indicates a link between depression during pregnancy and infant sleep problems.
This study examined sleep patterns in 18 healthy, full-term infants [...]
Pregnancy May Lower Lamotrigine (Lamictal) Blood Levels
May 5, 2009 – 9:40 am
Women with bipolar disorder are at increased risk for recurrence of illness during pregnancy. Therefore, many women with bipolar disorder elect to continue treatment with medications during pregnancy after weighing the risks and benefits of various treatment options with their physicians. Lamotrigine (Lamictal) is an anticonvulsant used to treat bipolar disorder. While the safety data [...]
Fetal Exposure to Valproate Associated with Lower IQ
April 24, 2009 – 10:06 am
There have long been concerns regarding the use of the anticonvulsant valproate (Depakote) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart, limbs, and genitals. A recent report published in the New England Journal [...]
Antenatal Use of Selective Serotonin Reuptake Inhibitors and QT Interval Prolongation in Newborns
March 24, 2009 – 10:08 am
Over the last several years, a number of studies have indicated that exposure to antidepressants near the time of delivery may be associated with poor neonatal outcomes. A recent prospective study from Dubnov-Raz and colleagues published in the journal Pediatrics found an association between QTc interval prolongation in neonates and antenatal exposure to selective serotonin [...]
Using New Research to Inform Treatment Decisions during Pregnancy: A Case Report
March 17, 2009 – 11:34 am
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 early [...]
Case: Prevention of Mood Episodes When Planning for Pregnancy
March 2, 2009 – 10:07 am
Our Perinatal and Reproductive Psychiatry team often discusses clinical cases in Rounds, a confidential forum in which we can get advice and consultation from peers who also work in the area of Women’s Mental Health. We discussed a patient’s situation recently that highlighted the controversial area about how to prevent mood episodes in a woman [...]
Severe Pregnancy Stress May Increase Schizophrenia Risk in Offspring
February 10, 2009 – 10:13 am
A study published in the Archives of General Psychiatry shows that children of women who experience the death of a close relative may have an increased risk of developing schizophrenia later in life. This study was conducted with records of children born in Denmark between 1973 and 1995, which were then linked to the central [...]
Cognitive Behavioral Therapy used to treat Depression in Pakistani Women
January 13, 2009 – 10:47 am
Mood disorders and symptoms during pregnancy and the postpartum period are not uncommon and affect women across the world. In spite of relatively high rates of depression among childbearing women, there are often inadequate resources for treatment, particularly in poorer countries. In countries lacking resources, health care is often managed by community health workers or [...]
Top 10 Blog Posts from the MGH Center for Women’s Mental Health
December 23, 2008 – 10:23 am
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 20, 2007
2. [...]
Dr. Lee Cohen talks with Dr. Oz about Pregnancy and Mood Disorders on Oprah.com
December 8, 2008 – 10:54 am
Earlier this year, Dr. Lee S. Cohen, Director of the MGH Center for Women’s Mental Health, spoke with Dr. Mehmet Oz from Oprah.com and a woman with bipolar disorder about mood disorders during pregnancy and weighing the risks of treatment options.
Click here to listen to the interview on Oprah.com.
Exercise and Depression
November 24, 2008 – 10:13 am
Exercise plays a vital role in achieving and maintaining good health. Along with numerous other health benefits, recent studies have shown that exercise alleviates symptoms of depression and may be useful in treating mild to moderate major depressive disorder (MDD). A study by Dunn and colleagues (2005) examined the efficacy of exercise as a treatment [...]
Substance Abuse Treatment During Pregnancy Improves Outcomes
November 17, 2008 – 11:12 am
Despite efforts over the last decade to increase awareness regarding the negative effects of alcohol and other drug use during pregnancy, substance abuse among pregnant women continues to be a significant problem in the United States. The 2003 National Household Survey on Drug Use and Health indicated that 9.3% of pregnant women used alcohol and [...]
Folic Acid Supplementation is Recommended for All Women Taking Anticonvulsants and Planning Pregnancy
November 11, 2008 – 10:07 am
Given recent discussions within our group and with our colleague, Lewis Holmes, MD, chief of the Genetics and Teratology Unit at Massachusetts General Hospital for Children and director of the North American AED (Antiepileptic Drug) Pregnancy Registry, I wanted to expand upon a previous blog post. In the initial post, I wrote that women who [...]
Depression during Pregnancy Increases the Risk of Preterm Delivery
November 3, 2008 – 10:07 am
A new study reported in Human Reproduction supports what many other studies have found, that untreated depression during pregnancy increases the likelihood of delivering before 37 weeks gestation.
In this prospective cohort study from by De-Kun Li and colleagues at the Kaiser Foundation Research Institute, women were screened for depression during the first trimester, at approximately [...]
Identifying Postpartum Depression: A Three Question Screening Tool
October 27, 2008 – 9:28 am
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 [...]
National Depression Screening Day – October 10, 2008
October 9, 2008 – 2:38 pm
This Friday, October 10, is Screening for Mental Health’s National Depression Screening Day, an effort to raise awareness for depression and its treatment.
The risk for depression is nearly twice as high in women as in men, and reproductive-aged women are at highest risk for developing depression. Numerous research studies suggest that untreated depression can have [...]
Post-Traumatic Stress Disorder (PTSD) Following Childbirth
October 8, 2008 – 9:17 am
Post-Traumatic Stress Disorder (PTSD) after childbirth is an understudied condition. Traditionally, much of the data have been based on case reports, indicating that PTSD can occur following a range of childbirth and child loss situations, including long or complicated labor, severe pain with labor or delivery, cesarean section, and unanticipated pregnancy outcome, such as child [...]
PPHN and SSRIs: Another Study Evaluating the Risk
September 16, 2008 – 9:57 am
In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Based on the results of this analysis, the authors estimated the risk of PPHN to be about 1% in infants exposed to SSRIs late in pregnancy (after 20 weeks). [...]
Impact of Infertility Treatment on Risk for Depression and Anxiety
August 28, 2008 – 9:29 am
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 [...]
Pre-Existing Psychiatric Illness is a Risk Factor for Postpartum Suicide Attempt
August 21, 2008 – 10:33 am
A recent population-based case-control study published in the American Journal of Obstetrics & Gynecology used Washington State birth certificates linked to hospital discharge data to evaluate the association between hospitalization for a psychiatric illness before delivery and risk of postpartum suicide attempt. The study compared women hospitalized for a postpartum suicide attempt (n [...]
Maternal Stress During Pregnancy Linked to Infant Sleep Problems
July 26, 2008 – 10:36 am
The link between maternal depression and anxiety during pregnancy and adverse neonatal outcome has been well-documented in the medical literature and reviewed on our website. A recent study published in the journal Early Human Development suggests that a mother’s stress during pregnancy may also negatively affect her baby’s sleep patterns.
In this longitudinal, prospective study, [...]
Psychological Stress During Pregnancy and Risk for Stillbirth
July 21, 2008 – 9:46 am
Previous studies have suggested that prenatal stress may be associated with a spectrum of adverse pregnancy outcomes, including preterm birth and low birth weight (reviewed in Hobel et al, 2008). A recent study from Danish researchers has investigated the impact of psychological stress on risk for stillbirth.
In this prospective cohort study, data from a [...]
Using Omega-3 Fatty Acids to Treat Depression During Pregnancy
June 25, 2008 – 9:10 am
We commonly see women in our consultation service who have histories of depression and are planning pregnancy. They frequently have questions about alternative treatments for depression while pregnant. Given that many women are taking omega-3 fatty acids prior to pregnancy, the question arises whether they should discontinue them during pregnancy. An additional question [...]
FDA Proposes Major Revision of Prescription Drug Labeling
June 10, 2008 – 9:52 am
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, [...]
Melatonin in Pregnancy: Is it Safe?
May 30, 2008 – 1:51 pm
Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. In a previous post, we discussed the use of different types of medications to treat insomnia during pregnancy. While these drugs are [...]
Maternal Stress and Low Birth Weight Predict Later Risk for Mood and Anxiety Disorders
May 22, 2008 – 9:49 am
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 [...]
Depression is Common Following Successful IVF
May 18, 2008 – 9:29 am
Psychological symptoms play a significant role in infertility. Some studies have examined the impact of psychological symptoms (e.g., anxiety, depression) on fertility status. Most of this research has focused on women with unsuccessful IVF treatment. Some have investigated the extent to which a woman’s psychological state during assisted reproductive therapy (ART, which [...]
Stress During Pregnancy Increases ADHD Risk
May 10, 2008 – 5:02 am
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 [...]
Eating Disorders in Pregnancy and Postpartum
May 8, 2008 – 11:59 am
The British Medical Journal recently published a brief, but comprehensive review of eating disorders in pregnancy by Veronica Bridget Ward. Eating disorders (anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified) most commonly occur in women of reproductive age and may be influenced by pregnancy and its associated weight gain and change [...]
New Study Does Not Find Link Between Paroxetine and Cardiovascular Defects
April 23, 2008 – 8:46 am
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 [...]
22nd Annual Postpartum Support International Conference
April 17, 2008 – 4:33 pm
The 22nd Annual Postpartum Support International (PSI) Conference will be held in Houston, TX from June 4 through June 7, 2008. The theme of this year’s conference is “Maternal Health, a Multisystemic View.” One of the featured speakers is Valerie Plame, former CIA agent and author of “Fair Game: My Life as [...]
Switching Antidepressants After the First Trimester
March 31, 2008 – 9:44 am
Q. I am currently talking Remeron for depression. I am about 16 weeks pregnant and doing well. I recently started working with a new psychiatrist, and my new doctor suggested that I switch to Prozac because he thought it would be safer for the baby. I am a little worried about making a change; I [...]
PPHN and SSRIs: New Findings
March 31, 2008 – 9:35 am
Over the past few years, multiple reports have raised questions regarding the safety of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. Chambers and colleagues reported that exposure to SSRIs late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). In the general population, PPHN affects about [...]
SSRIs and Pregnancy: Evaluating New Reproductive Safety Data
March 31, 2008 – 9:33 am
Over the past 15 years, multiple studies have addressed the reproductive safety of various antidepressants. Data on the overall teratogenicity of SSRIs has come from relatively small prospective observational studies, larger international birth registries, managed health care databases, and case series; these data have cumulatively supported the reproductive safety of fluoxetine and certain other SSRIs. [...]
Untreated Maternal Depression: What is the Impact on the Unborn Child?
March 27, 2008 – 2:47 pm
Depression during pregnancy is common. While concerns have been raised regarding the potential teratogenic and long-term neurobehavioral effects of psychotropic drug use during pregnancy, what is often overlooked is the fact that untreated maternal depression may also put the unborn baby at risk.
Maternal depressive symptoms during pregnancy have been shown to be associated with a [...]
Bipolar Disorder and Pregnancy: Should Medications Be Discontinued?
March 7, 2008 – 2:44 pm
As many of the traditional mood stabilizers used to treat bipolar disorder, including lithium and valproic acid, carry some teratogenic risk and the reproductive safety of other medications, including the atypical antipsychotic agents, has not been well-characterized, many women with bipolar disorder decide to discontinue their treatment during pregnancy. A new study from Dr. Adele [...]
Depression is More Common in Women with High Risk Pregnancies
March 6, 2008 – 10:52 am
Epidemiologic studies suggest that about 10% to 15% of women suffer from clinically significant depressive symptoms during pregnancy. Little is known, however, about the prevalence of depression among women with high risk pregnancies. A recent study published online in the Journal of Clinical Psychiatry suggests that this population may be at significant risk for [...]
Medication Changes During Pregnancy
February 28, 2008 – 10:44 am
At our clinic we have the opportunity to see patients at various stages of pregnancy. When we evaluate a patient while she is still in the planning stages, we may recommend changing medications to those that have a better studied safety profile during pregnancy and see how she does on those medications prior to [...]
ECT and Pregnancy
January 30, 2008 – 3:49 pm
Electroconvulsive therapy (ECT) is one of the most effective treatments for depression, with response rates that are consistently higher than those observed in clinical trials of antidepressants. Furthermore, ECT may be more effective than medications for treatment-refractory depression. The American Psychiatric Association (APA) recommends ECT for patients who have had previous positive response [...]
How to Treat Anxiety Symptoms During Pregnancy
December 11, 2007 – 7:57 pm
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
November 26, 2007 – 12:53 pm
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 [...]
Treatment of Insomnia During Pregnancy
November 19, 2007 – 11:48 pm
Most women experience some degree of sleep disturbance during pregnancy, and for a significant number of women sleep disruption may be quite severe. There are many different causes for sleep disturbance during pregnancy, and choosing the appropriate intervention relies on an accurate diagnosis of the problem.
Certain sleep disorders, such as restless leg syndrome and [...]
ACOG Opinion on SSRI Use During Pregnancy
November 12, 2007 – 2:49 pm
Recent reports have raised questions regarding the use of selective serotonin reuptake inhibitors (SSRI) during pregnancy. To date, no professional medical association has issued formal guidelines regarding the use of SSRIs during pregnancy. However, in December the American College of Obstetricians and Gynecologists ACOG published an opinion paper on this topic that is noteworthy for [...]
Binge Eating Disorder is More Common during Pregnancy
October 27, 2007 – 11:54 pm
While it appears that many women with eating disorders may experience a remission of their symptoms during pregnancy, a new study from researchers at the University of North Carolina, Chapel Hill and the University of Oslo, Norway suggests that binge eating disorder may be triggered during pregnancy.
The study included 41,157 women who self-reported eating disorder [...]
SSRIs and Pregnancy: Putting the Risks into Perspective
October 7, 2007 – 5:49 pm
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 [...]
Use of Wellbutrin (Bupropion) During Pregnancy
February 20, 2007 – 12:38 pm
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
February 20, 2007 – 8:32 am
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 [...]
Depression During Pregnancy is Often Not Treated
February 10, 2007 – 2:11 am
While pregnancy has traditionally been considered a time of emotional well-being, recent data indicate that about 10% to 15% of women experience clinically significant depressive symptoms during pregnancy. Furthermore, women with a history of major depression appear to be at high risk for recurrent illness during pregnancy particularly in the setting of antidepressant discontinuation. In [...]
Can Women Suffer from Postpartum Depression After Miscarriage?
October 19, 2006 – 8:18 pm
After the birth of a child, it is common for women to experience some type of mood disturbance. Typically, it is relatively mild (postpartum blues). However, about 10-15% of women experience a more severe and disabling illness, postpartum depression. It has been suggested that women who develop postpartum depression may be more sensitive to the [...]
Use of SSRIs During Pregnancy
July 30, 2006 – 1:40 pm
Q. I have been taking antidepressants on and off for the last ten years, and I am now planning a pregnancy. I am now on Effexor, and my psychiatrist recommended switching to Prozac and staying on it up until the end of the second trimester. He said that antidepressants should be avoided later on in [...]
Neurobehavioral Outcomes in Children Exposed to Lithium in Utero
July 30, 2006 – 1:17 pm
Driven by concerns regarding fetal exposure to psychotropic medications, many women with psychiatric illness attempt to discontinue their pharmacologic treatment during pregnancy; however, recent studies indicate that this approach may not be appropriate for all women. Dr. Adele Viguera and her colleagues at the Center for Women’s Mental Health have reported that among pregnant women [...]
Evaluating the Safety of First-Trimester Exposure to Lamotrigine (Lamictal)
July 11, 2006 – 1:30 pm
Early reports suggested that women with bipolar disorder may be at lower risk for onset or relapse of this disorder during pregnancy and that some women may be able to remain well during pregnancy despite medication discontinuation. However, more recent studies have suggested that recurrence of affective illness during pregnancy is relatively common among women [...]
Use of Paxil during Pregnancy
April 24, 2006 – 2:51 pm
Q. I have taken Paxil for about six years for depression and obsessive-compulsive disorder. I have tried several times to stop the medication but the symptoms come back within a few weeks of stopping the medication. My husband and I are now planning a pregnancy, and my obstetrician tells me that I cannot take Paxil [...]
Relapse of Major Depression during Pregnancy
April 22, 2006 – 9:22 am
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
January 24, 2006 – 6:53 am
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 [...]
Reviewing the Safety of SSRI’s in Pregnancy
December 31, 2005 – 2:24 pm
Over the past 15 years, multiple studies have addressed the reproductive safety of the selective serotonin reuptake inhibitors (SSRIs). Data on the overall teratogenicity of SSRIs come from relatively small cohort studies and larger international programs, and they have cumulatively supported the reproductive safety of fluoxetine (Prozac) and certain other SSRIs. However, several recent studies [...]
Atypical Antipsychotics during Pregnancy: What are the Risks?
December 30, 2005 – 2:42 pm
Although primarily used to treat schizophrenia and other psychotic disorders, the newer “atypical” antipsychotic agents are now used widely to treat a spectrum of psychiatric disorders, including major depression, bipolar disorder, PTSD and other anxiety disorders. While the reproductive safety of the older typical antipsychotic drugs, such as haloperidol (Haldol) and perphenazine (Trilafon), is supported [...]
Neonatal Symptoms After In Utero Exposure to SSRIs
July 27, 2005 – 7:21 am
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 [...]
Postpartum Depression: Who is at Risk?
June 20, 2005 – 3:39 pm
Many women imagine new motherhood as a time of total fulfillment, days filled with mother-infant bonding and boundless joy. In reality, however, many women experience significant mood changes following childbirth. Between 50 and 85% of new mothers experience a brief postpartum period of tearfulness and anxiety, termed the “maternity blues.” But some 10 to 15% [...]
Can Women Taking Lithium Breastfeed Their Infants?
June 14, 2005 – 6:46 pm
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 [...]
Should SSRIs Be Discontinued Prior to Delivery?
June 13, 2005 – 6:54 pm
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 [...]
Is Wellbutrin Safe During Pregnancy?
April 15, 2005 – 12:03 pm
Q. I have a long history of depression and have been taking Wellbutrin (bupropion SR) for several years now. Every time I try to come off the medication, the depression comes back. I am planning to get pregnant within the next year and was wondering if it is safe to use Wellbutrin.
A. While there is [...]
Acupuncture for Depression During Pregnancy
February 14, 2005 – 7:03 am
Depression during pregnancy is relatively common, affecting about 10 to 15% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, our understanding of how these psychotropic medications affect the developing fetus remains incomplete. For this reason, many women and their physicians would prefer to avoid the use [...]
Pregnancy and SSRIs: Is There a Risk to the Newborn?
October 15, 2004 – 9:50 am
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 [...]
Long-term Effects of Fetal Exposure to Antidepressants
March 31, 2003 – 12:25 pm
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 [...]
Anticonvulsants During Pregnancy in Women with Bipolar Disorder
October 6, 2002 – 4:00 pm
Unfortunately the mood stabilizers most commonly used to treat bipolar disorder (including lithium and valproic acid) can increase the risk of certain types of congenital malformations in children exposed [...]
Light Therapy for Depression During Pregnancy
June 23, 2002 – 12:31 pm
Depression during pregnancy (antenatal depression) is relatively common, affecting about 10% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, our understanding of how these psychotropic medications affect the developing fetus remains incomplete. For this reason, antidepressants are typically avoided during pregnancy; thus, there is a clear [...]
Lithium Discontinuation While Attempting to Conceive
February 6, 2002 – 11:21 am
For women with bipolar disorder who are planning a pregnancy, it is common practice to discontinue mood stabilizers prior to attempts to conceive, since the mood stabilizers most commonly used to treat [...]
Benzodiazepines and Pregnancy
May 6, 2001 – 4:08 pm
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 [...]
Selecting an Antidepressant During Pregnancy
May 6, 2001 – 3:42 pm
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 [...]
Bipolar Disorder and Pregnancy
January 6, 2001 – 10:53 am
Unfortunately the mood stabilizers most commonly used to treat bipolar disorder (including lithium and valproic acid) can increase the risk of certain types of birth defects or congenital malformations [...]
Preventing Depression During Pregnancy
May 6, 2000 – 4:13 pm
Women who take antidepressants for their depression must make a difficult decision when they plan to become pregnant. Should they continue their medication during pregnancy? Or should they stop? Although [...]
Serzone for Panic Disorder During Pregnancy
May 6, 2000 – 11:44 am
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. [...]
