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 [...]
Tag Archives: women’s mental health
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, [...]
MOTHERS Act Legislation Faces Opposition
June 4, 2008 – 11:13 am
The Melanie Blocker Stokes MOTHERS Act — named for an Illinois woman who committed suicide three months after giving birth — was approved by the House of Representatives in October. This article from the North Jersey Record reports that the legislation has been held up in the Senate Health, Education, Labor and Pensions committee.
Opposition [...]
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 [...]
Postnatal depression in men links to psychiatric illness in their children
May 26, 2008 – 10:53 am
While many studies have looked at the impact of postpartum depression in mothers on their children, there is very limited data on postnatal depression in the fathers and the potential impact it may have on their children.
Researchers at the University of Oxford recently examined predictors of postnatal depression in the fathers and studied the link [...]
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 [...]
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 [...]
Show Your Support for Postpartum Depression Legislation
May 2, 2008 – 12:04 pm
Please sign this online petition to support passage of The Melanie Blocker Stokes MOTHERS Act. A companion bill passed in the House of Representatives last fall to a nearly unanimous bipartisan vote. Democratic Senators Obama and Clinton both support this legislation along with Republican Senators including Olympia Snowe of Maine. Please help us gain our [...]
Do Oral Contraceptives Cause Mood Changes?
May 1, 2008 – 10:59 am
Many women have concerns about the side effects of oral contraceptives (birth control pills). Potential side effects include bloating, breast tenderness, and weight gain. In addition, some women may experience depression or mood swings, side effects that may influence a woman’s decision to start taking a birth control pill, particularly if she has [...]
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 [...]
Top Ten Blog Posts on the Women’s Mental Health Blog
March 21, 2008 – 10:59 am
Since the launch of our blog we’ve addressed many issues and questions in the field of Women’s Mental Health. Compiled below is a list of our most popular blog posts, on topics ranging from the safety of psychotropic drug use during pregnancy to postpartum depression.
1. Can Women Suffer from Postpartum Depression after Miscarriage? - Oct. [...]
New Research Study at CWMH: Treatment of Premenstrual Worsening of Depression
February 15, 2008 – 10:38 am
Seeking women between 18-45 with PMS who have been diagnosed with depression. If you are between 18 and 45 and:
Suffer with PMS
Currently being treated with an antidepressant
You may be eligible for a research study at Massachusetts General Hospital evaluating how a birth control pill helps with premenstrual mood symptoms. Women who participate will receive study [...]
Fertility and Antipsychotic Medications
February 14, 2008 – 10:37 am
Infertility is a problem which has gained increased attention over the past several decades. While many factors may contribute to infertility, some medications may also affect reproductive functioning and thus may have an impact on fertility. This post will focus on the antipsychotic drugs, which are now used to treat many psychiatric disorders [...]
Reproductive Age Women Need Folic Acid
February 7, 2008 – 10:26 am
A few weeks ago, January 7-13, 2008, was National Folic Acid Awareness Week at the Centers for Disease Control (CDC), therefore we wanted to take the opportunity to remind women of the importance of folic acid in the prevention of birth defects. Folic acid can prevent from 50-70% of neural tube defects, which are [...]
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 [...]
Nutritional Supplements for Premenstrual Syndrome: Do They Work?
January 24, 2008 – 3:48 pm
Many promote the use of certain vitamins and minerals for the treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), but controlled studies supporting the use of nutritional supplements are sparse.
There is some literature suggesting that the recommended dose of calcium (600 milligrams twice a day) can help to relieve mild to moderate [...]
Smoking While Breastfeeding: What Are the Risks?
January 22, 2008 – 10:09 am
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 [...]
Research Study at CWMH: Bipolar Disorder in Pregnancy
January 7, 2008 – 10:06 am
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 [...]
Depression Related to Childbirth Affects One in Seven Women
December 24, 2007 – 1:39 pm
Although pregnancy has often been concerned a time of emotional well-being, several recent studies have indicated that women are vulnerable to depression during pregnancy. Analyzing data from the Kaiser Permanente Northwest HMO, researchers assessed the prevalence of depression before, during, and after pregnancy in a group of 4,398 women with pregnancies ending in a [...]
What About Vagus Nerve Stimulation?
December 14, 2007 – 12:08 am
Vagus Nerve Stimulation, or VNS, has been available for the treatment of epilepsy since 1997 and was approved by the FDA for the adjunctive treatment of refractory depression in 2005. VNS relies upon the use of a surgically implanted device which delivers periodic stimulation to the vagus nerve. How VNS therapy works is [...]
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 [...]
Interaction Between Birth Control Preparations and Anti-Epileptic Medications
December 6, 2007 – 10:41 am
The interaction between specific birth control preparations and anti-epileptic medications should always be taken into consideration when developing a treatment approach, as taking the two simultaneously may decrease the birth control pill’s effectiveness.
An oral contraceptive (OC) is effective because it delivers high doses of estrogen to prevent ovulation. Unfortunately, some anti-epileptic medications alter the metabolism [...]
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 [...]
Oral Contraceptives for the Treatment of Premenstrual Mood Symptoms
November 13, 2007 – 6:44 pm
Oral contraceptives are commonly prescribed for the treatment of premenstrual symptoms and premenstrual dysphoric disorder (PMDD); however, the evidence supporting the use of oral contraceptives in this setting is limited. While most studies have shown that oral contraceptives are not effective for the treatment of premenstrual symptoms, there is preliminary evidence that a new [...]
Paroxetine CR May Be Helpful for Menopausal Women Discontinuing Hormone Therapy
November 12, 2007 – 6:40 pm
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 [...]
Can Estrogen Be Used to Treat Posptartum Depression?
November 6, 2007 – 4:41 am
After delivery, women experience a dramatic drop in estrogen hormone levels. Many have hypothesized that this decline in estrogen levels may precipitate postpartum depression (PPD) in susceptible individuals, and several studies have explored the use of estrogen for the treatment of depression after delivery.
In a double blind, placebo-controlled study including 61 women with PPD, [...]
Sleep Problems in Menopausal Women
November 3, 2007 – 5:22 am
Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primary sleep disorder.
In this study, 102 women (ages 44 to [...]
Does Estrogen Improve Cognition?
October 30, 2007 – 5:38 pm
While earlier observational studies suggested that postmenopausal hormone treatment may improve cognitive functioning in women, studies from the Women’s Health Initiative have shown that estrogen replacement therapy started in postmenopausal women (65 years or older) did not enhance cognitive functioning nor did it decrease the risk of dementia.
In order to assess the effect of [...]
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 [...]
Link Found Between Anxiety and Preterm Birth
October 22, 2007 – 9:32 am
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 [...]
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 [...]
Panic Attacks in Older Women Linked to Heart Disease
October 2, 2007 – 11:44 pm
An article published in the October 2007 issue of Archives of General Psychiatry suggests that older women who experience panic attacks may be at increased risk of having a heart attack or stroke and at increased risk of death over the next five years. MGH researcher Jordan W. Smoller, M.D. and colleagues followed 3,369 healthy [...]
Antidepressant-Induced Sexual Side Effects
October 1, 2007 – 1:06 am
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, [...]
Two MGH Center for Women’s Mental Health Physicians Featured in Elle Magazine
September 28, 2007 – 12:13 pm
Lee S. Cohen, MD, and Hadine Joffe, MD, MSc, shared their expertise in reproductive health and oral contraceptives (OC) for Elle magazine’s recent article, “Against the Flow.” The article discusses Lybrel, the first continuous OC approved by the Food and Drug Administration (FDA). This new birth control pill has received attention because its continual low [...]
Expert Guidelines for the Treatment of PMDD
August 31, 2007 – 5:45 pm
In this review, guidelines for the treatment of PMDD are provided.
Selective serotonin reuptake inhibitors (SSRIs) are the most widely used pharmacologic agents for treating depression and anxiety disorders, and several have also emerged as first-line treatment for premenstrual dysphoric disorder (PMDD). In numerous clinical trials, SSRIs have demonstrated efficacy in reducing the physical and behavioral [...]
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 [...]
Perimenopause May Be a Time of Risk for New Onset Depression
February 10, 2007 – 12:35 pm
The transition to menopause has typically been considered a time when women may be more vulnerable to mood changes. There have been inconclusive data, however, as to whether women with no lifetime history of depression transitioning to menopause are at increased risk for developing an episode of major depression.
In a recent study, Drs. Lee Cohen [...]