Understanding the Heterogeneity of Perinatal Depression
Most studies evaluating the prevalence of perinatal depression are cross-sectional, meaning that depressive symptoms are measured at a single point in time. Less information is available regarding the trajectory of perinatal depression. In obstetric populations, it seems that there are women with briefer episodes of milder postpartum depressive symptoms, while others have more persistent and debilitating depressive symptoms after childbirth. Other women experience depression during pregnancy. Several studies suggest that there is considerable heterogeneity among women who experience depressive symptoms during pregnancy and the postpartum period.
Good News: New Studies Show No Association Between Antidepressants and Risk of Autism
Two recent epidemiologic studies have demonstrated an association between prenatal exposure to selective serotonin reuptake inhibitor antidepressants (SSRIs) with autism spectrum disorders (ASD; Croen et al 2011, Rai et al, 2013). One important imitation of these two studies is that parental psychiatric disorder in itself is associated with an increased risk of ASD in the offspring, and these studies could not distinguish between the effects of drug exposure and the consequences of the underlying maternal psychiatric illness. Two new studies shed light on the association between prenatal antidepressant exposure and risk of autism spectrum disorder in the offspring.
Folic Acid Supplements Before and After Conception: Prevention of Autism
In a recent editorial in The Annals of Internal Medicine entitled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” authors make a case that multivitamins are not a good value (Dec 17, 2013 issue). This editorial was based on new research that demonstrated that there was no association between multivitamin use and rates of mortality, cognitive decline and recurrent cardiovascular events in three different studies. The assertion that multivitamins are not worth the money was widely reported in the media.
Progesterone for Hot Flashes
Following the publication of the Women's Health Initiative report in 2002, there was a dramatic drop in the use of hormone-replacement therapy (HRT) due to concerns about increased risk of heart disease, breast cancer, and stroke. Since that time, various non-hormonal alternatives have been utilized for the treatment of menopausal symptoms, including gabapentin and various serotonin reuptake inhibitors.
SSRIs and PPHN: Are We Any Closer to Calculating the Risk?
The PPHN story has been a bit of a rollercoaster. Just to review…
Adjusting Psychotropic Drug Dosages for Women
Although we do not typically adjust the dosage of medications based on gender, there are certain medications which may have different pharmacokinetics and rates of metabolism in women versus men.