Recent Posts

Up to 80% of women experience symptoms as they transition into the menopause, including vasomotor symptoms, sleep disturbance, and depressive symptoms.  While hormone replacement therapy and certain medications may be helpful, these interventions may have side effects.   In a recent study, 71 peri- or postmenopausal women who were seeking treatment for menopausal symptoms, including vasomotor symptoms and at least mild depressive symptoms, were randomly assigned to cognitive behavioral therapy for menopause (CBT-Meno; n = 37;...

We’ve come a long way.  Prior to the 1980s, most new mothers had never heard of postpartum depression.  Over the last few decades we have made considerable progress in educating women about their risk for psychiatric illness during this vulnerable time, and women now have a much more sophisticated understanding of depression as a real, but treatable, illness. In 2010, the American College of Obstetricians and Gynecologists (ACOG) recommended screening for depression in all pregnant...

Brexanolone, marketed by Sage Therapeutics as Zulresso, was approved in March 2019, as a treatment for postpartum depression.  It has been available for almost two months, and we are very eager to hear about patients’ and clinicians’ experiences with this new medication.   Because of some concerns about Zulresso’s side effects, including excessive sedation and sudden loss of consciousness, it was released through a Risk Evaluation and Mitigation Strategy (REMS) program that requires the drug to...

It seems that there is considerable variation in the estimated prevalence of suicidal ideation in pregnant and postpartum women across studies. One element that may contribute to this variation is how we assess for this symptom. Many studies use self-report questionnaires, such as the Edinburgh Postnatal Depression Scale (EPDS) which asks how often “the thought of harming myself has occurred to me”. Other studies use the Patient Health Questionnaire or PHQ-9 which asks how often...

Opioid use in pregnant women is a significant public health concern.  A recent study observed that one out of five pregnant women (21.6%) filled a prescription for an opioid and 2.5% received a chronic opioid prescription for greater than 30 days.  It is estimated that the number of pregnant women diagnosed with an opioid use disorder (OUD) has more than quadrupled over a 15-year period ending in 2014, increasing from 1.5 to 6.5 per 1000...

Anxiety disorders affect nearly 1 in 5 adults in the United States, and women are about  twice as likely as men to suffer from an anxiety disorder at some point in their lifetime.  According to a recent meta-analysis published in the Journal of Clinical Psychiatry, one in five pregnant women experience at least one type of anxiety disorder.  Given the high prevalence of anxiety disorders among women, the Women’s Preventive Services Initiative (WPSI) issued a...