Why Are We Still Using Valproic Acid (Depakote) in Women of Childbearing Age?
 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. Prenatal exposure to valproate may also result in lower IQ and increased risk of autism spectrum disorders in the offspring.  Despite these significant risks, [...]
Ovarian Suppression for PMDD: New Study Suggests Long-Term Effectiveness and Tolerability
PMDD or premenstrual dysphoric disorder has always been a bit of mystery. Â We explain that PMDD is triggered by changes in reproductive hormone levels, but when you look at hormone levels in women with PMDD, they do not differ significantly from the hormone levels of women without PMDD. Â Another question is why some women develop PMDD later in their reproductive lives. Â PMDD most commonly has its onset not at menarche but [...]
In Brief: High Rates of Marijuana Use in Pregnant Teens
According to data from the 2002-2015 National Survey on Drug Use and Health, the prevalence of marijuana use was 3.8% in pregnant women (n=14,400), compared to 7.5% in nonpregnant women (n=395,600). Â Â The investigators observed that marijuana use was higher in the first trimester (6.4%) than in the second (3.3%) or third (1.8%) trimesters. Â Marijuana use was higher in pregnant black women (6.5%) than in white (3.8%) or Hispanic women(2.9%) or women [...]
Brexanolone: Related to Allopregnanolone, Effective for the Treatment of Postpartum Depression
In 2015, we first reported on SAGE-547 (SAGE Therapeutics), a new medication for the treatment of severe postpartum depression. Â SAGE-547, now called brexanolone, is an allosteric modulator of GABAA receptors. Â This drug was initially under investigation for the treatment of refractory seizure disorders but it turned out to be a good antidepressant. Â The information we presented in 2015 was from a press release put out by Sage Therapeutics; their findings were [...]
Lamotrigine and Pregnancy: Meta-Analysis Shows No Increase in Risk for Malformations
 Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree of teratogenic risk. In contrast, lamotrigine (Lamictal) appears to be a much safer option for use during pregnancy. Researchers analyzed a total of 21 studies describing pregnancy outcomes and rates of [...]
Weekly Roundup for MAY 5, 2017: Recent Publications in Women’s Mental Health
 A slow week.  There is more concerning data regarding the use of marijuana in pregnant women, which is prevalent in pregnant teens.  And an elegant study from Peter Schmidt and David Rubinow which gives us more information regarding the etiology of PMDD and potential strategies for its management.   Marijuana Use During Stages of Pregnancy in the United States. Volkow ND, Han B, Compton WM, Blanco C. Ann Intern [...]