Why Do Many Continue To Recommend Tapering SSRI Antidepressants During the Third Trimester?
In 2005, we saw the first reports describing an increased risk of “poor neonatal adaptation” in infants with prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy. Since that time, studies have consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaptation. The most commonly observed symptoms include jitteriness, restlessness, irritability, increased muscle tone, sleep disturbance, feeding problems, [...]
The Etiology of Premenstrual Dysphoric Disorder: 5 Interwoven Pieces
The following post was first published in Current Psychiatry, published September 2017, Vol. 16, No. 9, p. 20-28. Check out the article on Current Psychiatry or listen to Dr. Raffi discuss treatment of menstrual–related mood and anxiety disorders. By Edwin R. Raffi, MD, MPH, & Marlene P. Freeman, MD In an age when psychiatry strives to identify the biologic causes of disease, studying endocrine-related mood disorders is particularly intriguing. DSM-5 defines premenstrual dysphoric [...]
Antenatal Exposure to Antidepressant and Risk of Psychiatric Illness in the Child
When we provide consultations regarding the use of antidepressants during pregnancy, one of the most difficult questions we have to answer is related to the long-term effects of prenatal antidepressant exposure. Specifically, do antidepressants used by the mother during pregnancy affect the long term development of the fetus? While many studies have attempted to look at the effects of prenatal antidepressant exposure on neurodevelopment and behavior, most of these studies [...]
Estrogen Receptor Modulator Raloxifene for Women with Schizophrenia
Several years ago, we reviewed a paper suggesting that estrogen may have beneficial effects for women with schizophrenia. In this study, women with schizophrenia were treated with estrogen in addition to their antipsychotic medications. Adjunctive treatment with estrogen was associated with significant improvement in their positive symptoms (hallucinations, delusions), but the women experienced no improvement in the severity of negative symptoms (reduction in range of emotional expression, poverty of speech, lack [...]
Weekly Roundup for AUGUST 31, 2017: Recent Publications in Women’s Mental Health
A new study looks at the effects of telephone-delivered depression care management in postpartum women. The July issue of Birth Defects Research features a collection of reviews on perinatal mental health. Telephone-Based Depression Care Management for Postpartum Women: A Randomized Controlled Trial. Wisner KL, Sit DKY, McShea M, Luther JF, Eng HF, Dills JL, Moses-Kolko EL, Wisniewski SR. J Clin Psychiatry. 2017 Aug 8. In women with postpartum depression, clinicians [...]
Prenatal Exposure to Benzodiazepines and Sedative-Hypnotics
Over the last decade, we have seen multiple studies looking at the long term effects of prenatal exposure to antidepressants, particularly the selective serotonin reuptake inhibitors or SSRIs, on children's behavior. Although benzodiazepines, such as lorazepam (Ativan) and clonazepam (Klonopin), and sedative-hypnotic medications are used relatively frequently during pregnancy, we have much less information regarding the long-term effects of prenatal exposure to these medications. Using data from the Norwegian Mother and [...]