Treatment of Opioid Addiction During Pregnancy: Buprenorphine
The use of opioid drugs in women of childbearing age has become a pressing public health concern. Â It is clear that opiate use during pregnancy puts the mother and child at risk; opiate use during pregnancy has been associated with increased risk for oral clefts, neural tube defects, gastroschisis, congenital heart defects, and ophthalmic problems. Â Obstetrical complications are more common in women using opioids during pregnancy and include maternal cardiac arrest, [...]
The Pediatric Emergency Department: Another Opportunity for Postpartum Screening
Earlier this year, the U.S. Preventive Services Task Force (USPSTF) released recommendations on Screening for Depression in Adults. The Task Force recommends that clinicians screen ALL ADULTS for depression and notes that the evidence indicates that screening in the primary care setting is beneficial. Echoing the recommendations made by the American College of Obstetricians and Gynecologists last year, the USPSTF highlights the importance of screening in populations at particularly high risk [...]
Premenstrual Mood Disorders and Postpartum Depression: Similar But Different
It has been hypothesized that both premenstrual dysphoric disorder (PMDD) and postpartum depression (PPD) occur as the result of rapid shifts in the levels of ovarian hormones. Data regarding the prevalence of PPD among women with documented PPD is sparse, and the existent studies rely upon recall of premenstrual symptoms which is notoriously inaccurate. Â Despite this lack of information, we often tell women with PMDD that they may be at increased [...]
What Are the Long Term Effects of Prenatal Antidepressant Exposure?
At this point in time, we have considerable information regarding the reproductive safety of antidepressants, particularly the selective serotonin reuptake inhibitors or SSRIs. Â Most of this information relates to the incidence of congenital malformations or birth defects in children exposed to these medications. Â Other studies have examined the effects of the medications on newborn adaptation and behavior. Â Our information is, however, much more limited when it comes to understanding the long [...]
HEART: An Innovative Program for Identifying and Treating Adolescent Mothers with Depression
Multiple studies have shown that routine medical care is not adequate when it comes to identifying and treating women with perinatal mood disorders. Â Universal screening can help to increase the identification of mothers with mood and anxiety disorders during pregnancy and the postpartum period; however, there are still significant obstacles in terms of accessing mental health services. Teen mothers are at high risk for perinatal mood and anxiety disorders. Â In this [...]
Lamotrigine and Pregnancy: New Study, No Significant Increase in Risk of Oral Clefts
The anticonvulsant lamotrigine (Lamictal) is being used with increasing regularity for the treatment of women with bipolar disorder. Â Back in 2006, we reported on preliminary data indicating an increased risk of oral clefts among infants exposed to lamotrigine during the first trimester of pregnancy. Â It has been a while since we reviewed the data regarding the reproductive safety of lamotrigine, so this seems like a good time to review the data [...]