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Blog2023-08-08T17:17:12-04:00

Pregnancy May Lower Lamotrigine (Lamictal) Blood Levels

Women with bipolar disorder are at increased risk for recurrence of illness during pregnancy.  Therefore, many women with bipolar disorder elect to continue treatment with medications during pregnancy after weighing the risks and benefits of various treatment options with their physicians.  Lamotrigine (Lamictal) is an anticonvulsant used to treat bipolar disorder. While the safety data on this relatively new anticonvulsant in pregnancy is limited, pregnancy registry data suggests that lamotrigine may pose less of a risk to the developing fetus than with older anticonvulsants, such as valproate (Depakote). With lamotrigine emerging as an effective and relatively safe treatment for pregnant women with bipolar disorder, more attention is now being paid to the effects of pregnancy on lamotrigine levels.

May 5th, 2009|

Fetal Exposure to Valproate Associated with Lower IQ

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. A recent report published in the New England Journal of Medicine indicates that in utero exposure to valproate may also result in lower IQ.     

April 24th, 2009|

Cognitive Behavioral Therapy for Premenstrual Syndromes: A Review of the Literature

Significant numbers of reproductive-aged women experience premenstrual syndromes characterized by depressed mood, irritability, mood swings, anxiety or tension, sleep disruption, and other physical symptoms, including bloating and breast tenderness. Typically these symptoms emerge during the week preceding menstruation, improve with the onset of menses, and are not present during the week after menstruation.

April 6th, 2009|

Screening for Metabolic Side Effects of Atypical Antipsychotics

Atypical antipsychotics are increasingly used to treat psychiatric disorders such as bipolar disorder or schizophrenia.  In spite of the important role they play for many patients in treating serious psychiatric disorders, atypicals have been associated with negative side effects that may worsen a patient's cardiovascular health profile.  This includes a greater risk for weight gain, glucose dysregulation/diabetes, and dyslipidemia (elevated triglycerides/cholesterol).

March 31st, 2009|

Antenatal Use of SSRIs and QT Interval Prolongation in Newborns

Over the last several years, a number of studies have indicated that exposure to antidepressants near the time of delivery may be associated with poor neonatal outcomes. A recent prospective study from Dubnov-Raz and colleagues published in the journal Pediatrics found an association between QTc interval prolongation in neonates and antenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants.  The QT interval is a measurement of the heart's electrical cycle from ventricular depolarization to the end of ventricular polarization.  It is determined from an electrocardiogram (ECG) and is corrected for heart rate. 

March 24th, 2009|
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