Clinical Case: Should SSRIs Be Tapered Prior To Delivery?
Ms. T is a 33 year old woman with a history of recurrent depression who is 32 weeks   pregnant with her first pregnancy. She has remained on her citalopram (Celexa) throughout pregnancy and has been well. Her gynecologist has encouraged her to enquire about coming off the Celexa prior to delivery in order to avoid symptoms of neonatal distress. What should she do?
Postpartum Depression and Poor Sleep Quality Occur Together
In a new mother, sleep is disrupted by repeated awakenings of the infant, but hormonal factors also seem to play a role. Immediately after childbirth, levels of the reproductive hormones, estrogen and progesterone, drop precipitously. It is believed that, because these hormones modulate neurotransmitter systems in the brain responsible for sleep quality, this dramatic hormonal shift may cause significant disruptions in sleep.
In Utero Exposure to Antipsychotics
May 2011, ObGyn News, Lee S. Cohen, MD
Choice of Antidepressant May Affect Survival in Women on Tamoxifen for Breast Cancer
Tamoxifen is a SERM (selective estrogen receptor modulator) used in women with breast cancer; it reduces the risk of relapse and improves overall survival. Tamoxifen may also be used to reduce the risk of breast cancer in women at high risk for the disease. In order to be fully effective, tamoxifen must be metabolized to an active metabolite, endoxifen, by the liver enzyme CYP2D6. Consequently, any co-administered agent that inhibits this enzyme will reduce the conversion of tamoxifen to endoxifen, thereby potentially reducing the efficacy of tamoxifen as a breast cancer therapy.
Anxiety During Pregnancy: How Does it Affect the Developing Fetal Brain?
During fetal life, neurons proliferate, migrate and form connections, providing the structure of the developing brain. Neurons reach their final destinations by the 16th week of gestation, while branching and making appropriate connections occur even before that time (1). The brain continues to develop during the entire pregnancy, with most of the synapse formation in the developing brain happens during the third trimester (2).
Cognitive-Behavioral Therapy for Infertile Women: Is it Better than Medication?
Research indicates that women undergoing infertility treatment experience high rates of psychological distress (1). Additionally, it is believed that stress and depression have an impact on fertility, as it has been shown that certain psychological interventions may improve pregnancy rates in infertile women (2-4). In a recent study, Faramarzi and colleagues compared the effects of group cognitive behavioral therapy (CBT), fluoxetine, and no treatment on the mental health of infertile women who had been trying to conceive for at least 2 years (5).