Does Sleep Deprivation Trigger Postpartum OCD?
Obsessive compulsive disorder (OCD) may emerge during the postpartum period, either as the first onset of illness or as a recurrence of preexisting OCD. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) does not recognize postpartum OCD as a distinct diagnostic entity. In contrast, other psychiatric disorders (i.e., major depressive disorder, bipolar disorder, or brief psychotic disorder) may be specified using the peripartum onset specifier. The fact that [...]
Antidepressants Reduce Risk of Depression During Pregnancy, Individualized Treatment Essential
For women with histories of major depression, choosing whether to maintain or to discontinue treatment with an antidepressant during pregnancy is often challenging. This is a process which requires careful and thoughtful consideration, weighing the risk of adverse outcomes associated with exposure to a particular antidepressant against the risk of recurrent illness in the setting of medication discontinuation. In a recent study, Bérard and colleagues assessed risk for depressive symptoms in [...]
In Brief: FDA Approves New Drug to Improve Sexual Desire in Women
The Food and Drug Administration (FDA) has approved a new drug for the treatment of hypoactive sexual desire disorder in premenopausal women. Bremelanotide (to be marketed as Vyleesi) is used on-demand. Bremelanotide is a peptide which acts as a melanocortin receptor agonist. Its mechanism of action is distinct from flibanserin and is thought to have a better side effect profile.  When injected under the skin of the abdomen or thigh at [...]
Behavior Problems More Common In Children with Prenatal Exposure to Valproic Acid
While we have considerable information regarding the teratogenic risk associated with prenatal exposure to various antiepileptic (AED) drugs, we have less impact on exposure to AEDs on behavior outcomes in children. Several studies have shown that exposure to valproic acid may be associated with increased risk of autistic traits and/or attentional problems; however, we have less information on risk for other behavior problems.  In a prospective observational study, carried out in [...]
Weekly Roundup for JULY 12, 2019: Recent Publications in Women’s Mental Health
Although there are data to support the use of many different antidepressants and other psychotropic medications, many women and their providers would prefer to avoid the use of medications during pregnancy. Options for non-pharmacologic treatment are limited. Some women respond to psychotherapy; however, we often see women with histories of depression who have experienced recurrent depression after discontinuing treatment. Vigod and colleagues explore the efficacy of transcranial direct current stimulation (tDCS) [...]
Brexanolone (Zulresso) for Postpartum Depression Cleared by the DEA, Now Available
Brexanolone, to be marketed by Sage Therapeutics as Zulresso, was initially approved in March 2019, as a treatment for postpartum depression. At that time, we were told that Zulresso would be available in June 2019. Here are a few updates. The Drug Enforcement Administration (DEA) has recommended that brexanolone be placed in schedule IV of the Controlled Substances Act (CSA). This decision is based, not on experiences in the field, but [...]