Assessing the Reproductive Safety of Antidepressants: Can Non-Randomized Studies Provide the Information We Need?
Perinatal psychiatry is a field in which we treat vulnerable patients, a mother and her child, where both the illness we are treating and the treatments we prescribe have the potential to affect the outcome. There is a deep and compelling literature that describes the negative impact of postpartum depression upon children, and we are constantly learning more about the short and long-term effects of depression and anxiety during pregnancy on [...]
Fertility Treatment in the Midst of a Pandemic
In March, when the COVID-19 pandemic hit Massachusetts, centers providing infertility services were forced to hit the pause button, leaving many couples in the United States in the lurch. On March 17, the American Society of Reproductive Medicine (ASRM) issued guidelines for fertility specialists which consisted of five key recommendations, including the suspension of new treatment cycles and the cancellation of embryo transfers, as well as postponing elective surgeries.  Given the [...]
Pilot Study of Neurosteroid Ganaxolone for Menopausal Depression
Over the last few years we have heard a great deal about neurosteroids, also known as neuroactive steroids. This class of compounds are steroid hormones produced in the brain and endocrine tissues which can modulate neurotransmission. Animal studies have demonstrated that neurosteroids have a broad range of activities, including antidepressant, anxiolytic, sedative, analgesic, anticonvulsant, neuroprotective, and neuroproliferative effects. Several different neurosteroids have been tested as anticonvulsants and anaesthetic agents; however, we [...]
Weekly Roundup for AUGUST 28, 2020: Recent Publications in Women’s Mental Health
Every week we review the most recent publications in women’s mental health, covering topics related to premenstrual symptoms, perinatal mood and anxiety disorders, use of medications in pregnant and breastfeeding women, perinatal substance use, and menopausal mental health. It's hard to believe that September is upon us. A few reminders. We will continue to offer our Wednesday virtual rounds. You can sign up HERE. This is a great opportunity to discuss [...]
CBT-Based Group Intervention Improves Perinatal Depression and Maternal Sensitivity
Previous research has shown that higher levels of depressive symptoms during pregnancy may be associated with lower levels of maternal-fetal attachment (MFA). Other studies have indicated that poor MFA is a significant predictor of worse outcomes in terms of mother-infant interactions and infant attachment security. A new study looks at an intervention designed to treat maternal depression and assesses the impact of this intervention on maternal sensitivity and attachment.  This pilot [...]
Another Study on Antidepressants and Birth Defects: Does it Change Our Decision-Making?
Prozac (fluoxetine) was the first SSRI or selective serotonin reuptake inhibitor. Since its release in 1988, we have been gathering data on the reproductive safety of fluoxetine and other SSRIs. Over the last 32 years, we have collected an enormous amount of data on the use of SSRIs during pregnancy -- far more information than we have on other medications commonly used during pregnancy. The data has been reassuring, and based [...]