What Would You Do? A Pregnant Women on Duloxetine (Cymbalta)
Ms. A is a 27-year-old woman who is seven weeks pregnant and is currently taking duloxetine (Cymbalta). She has a history of recurrent major depressive disorder (MDD) and has had a good response to duloxetine at 60 mg per day. She has had four previous episodes of major depressive disorder (most untreated) and has been in remission for one year. Past episodes have lasted up to six months and caused difficulty with functioning at work and in relationships, although she was not diagnosed and treated until one year ago.Â
Do SSRIs Increase the Risk of Preeclampsia?
Hypertension in pregnancy is generally defined as a diastolic blood pressure of 90 mm Hg or greater or a systolic pressure at or above 140 mm Hg. Preeclampsia is defined as the development of hypertension with proteinuria or edema induced by pregnancy, generally in the second half of gestation. It is more common in women who have not carried a previous pregnancy beyond 20 weeks and in women at the extremes of the reproductive years.
Omega-3 Fatty Acids for Depression in Women
An ideal treatment for major depressive disorder (MDD) in women would be efficacious, safe, and offer broad health benefits. MDD is prevalent in women of childbearing years, and recent research underscores the risk of recurrence of mood episodes during pregnancy. Concerns many women and their health care providers have about antidepressant exposure during pregnancy and breastfeeding increase the public health significance regarding safe non-medication treatment options. Omega-3 fatty acids have been [...]
OCD in Pregnant and Postpartum Women
The lifetime prevalence rate of obsessive-compulsive disorder (OCD) has been consistently estimated to be 2%-3% in the general adult population throughout the world, making OCD one of more common psychiatric diagnoses; however research on OCD in pregnancy and peurperium has been limited.
Use of Complementary and Alternative Medicines for Menopausal Hot Flashes
Approximately seventy percent of all women experience hot flashes and/or night sweats (also called vasomotor symptoms) during the menopause transition (Stearns et al. 2002). Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes. Since the results of the Women's Health Initiative in 2002 noted risks of prolonged use of hormone therapy in older postmenopausal women (Roussouw et al. 2002), many women pursue other treatments for their hot flashes, including over-the-counter complementary and alternative medicines (CAMs), including soy isoflavones, black cohosh, and omega-3 fatty acids. However, there is limited evidence to support the use of these treatments for hot flashes to date.
Postpartum Depressive Symptoms Increase the Risk of Smoking Relapse
While many women who smoke successfully quit smoking during pregnancy, most of these women return to smoking within 12 months of delivery. Several studies have suggested that certain factors may increase the risk of postpartum relapse, including unwanted pregnancy, multiparity, and stressful life events. Two recent studies indicate that postpartum depressive symptoms may also increase the risk of smoking relapse after delivery.