Clinical Update (2019): Is Oxcarbazepine (Trileptal) Safe to Use During Pregnancy?

We don’t hear this clinical question so often but it does come up from time to time.  While the anticonvulsant oxcarbazepine (Trileptal) was initially promoted as a mood stabilizer for patients with bipolar disorder, it is not widely used in this setting, which may stem from the limited data supporting its efficacy in this patient population.  However, we do see women who are taking this oxcarbazepine and ask about the reproductive [...]

April 22nd, 2019|

Improving Sleep May Relieve Depressive Symptoms in Menopausal Women

Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a study from researchers at Wayne State University School of Medicine suggests that a sizeable proportion of menopausal women may have a primary sleep disorder.  Clinically we see that sleep disruption, especially when prolonged, can lead to a constellation of other symptoms including irritability, anxiety, depression, and poor cognitive [...]

April 17th, 2019|

Risk Factors for Perinatal Suicide

While depression is a relatively common occurrence during the perinatal period, suicide is less common in pregnant and postpartum women than in other populations.  Because suicide in this population is rare, we have limited information regarding risk factors for suicide during the perinatal period. A new study published in Lancet Psychiatry attempts to identify risk factors in this population. This study analyzed data collected from 1997–2012 as part of the United [...]

April 17th, 2019|

Anti-Epileptic Drugs in Reproductive eAge Women: Valproic Acid and Topiramate Commonly Used

There have long been concerns regarding the safety of the anticonvulsant valproic acid (Depakote) during pregnancy.  Back in 2009, the American Academy of Neurology and American Epilepsy Society recommended against the use of valproic acid in women of childbearing age because of the various risks associated with prenatal exposure, citing significantly increased risk of congenital malformations (including neural tube defects) and a spectrum of neurodevelopmental deficits.   A recent study, which [...]

April 9th, 2019|

Weekly Roundup for MARCH 29, 2019: Recent Publications in Women’s Mental Health

Most women with depression experience considerable difficulty in making decisions about whether or not to use antidepressant medications during pregnancy. These decisions are very complex, and women must consider their own illness history and personal preferences in the context of available data regarding the reproductive safety of antidepressants.   Simone Vigod and colleagues present preliminary data online patient decision aid (PDA) for the use of antidepressants during pregnancy. On this list are [...]

March 30th, 2019|

A Primer on Brexanolone (Zulresso) for Postpartum Depression

Since the the Food and Drug Administration (FDA) approved brexanolone as an intravenous infusion for the treatment of postpartum depression last week, we have been deluged with questions from patents, providers and the media regarding this new drug.  Sage Therapeutics plans to market the drug under the name ZULRESSO and plans to launch in the United States in June 2019.   What is brexanolone (Zulresso)? How does it work? Brexanolone (introduced [...]

March 28th, 2019|