• Yearly Archives: 2011

    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).

    Atomoxetine Improves Memory and Attention in Peri- and Postmenopausal Women

    Many peri- and post-menopausal women describe problems with memory and attention.  Data regarding the use of estrogen replacement therapy to improve cognitive functioning has been mixed.  Furthermore, recent concerns regarding the long-term risks of ERT have limited its use.  A recent report from C. Nell Epperson and colleagues from the University Of Pennsylvania School Of Medicine indicates that atomoxetine (Strattera), a treatment for attention-deficit/hyperactivity disorder (ADHD), may improve attention and reduce memory difficulties in perimenopausal and postmenopausal women.

    Methadone and Breastfeeding

    Up until 2001, the American Academy of Pediatrics (AAP) recommended that methadone was compatible with breastfeeding in women taking less than 20 mg per day.  Because most women on methadone maintenance therapy typically require 50 to 15o mg of methadone per day during pregnancy, this meant that most women on methadone were not able to breastfeed. However, the dose restriction for methadone was eliminated in 2001, a decision driven by several studies indicating that the levels of methadone secreted into human breast milk were relatively low.

    New FDA Warning on the Use of Antipsychotic Medications in Pregnancy

    On February 22, 2011, the U.S. Food and Drug Administration (FDA) informed healthcare professionals that drug labels for the entire class of antipsychotic drugs have been updated to include warnings regarding the use of antipsychotic drugs during pregnancy. The new drug labels now contain more details on the potential risk for abnormal muscle movements (extrapyramidal signs or EPS) and withdrawal symptoms in newborns exposed to these drugs during the third trimester of pregnancy.

    New Research from the CWMH: Escitalopram (Lexapro) for Hot Flashes

    For decades, estrogen has been used to treat menopausal symptoms, including night sweats and hot flashes.  However, after studies reported that estrogen increases the risk of cardiovascular disease and breast cancer, many patients and clinicians have looked into alternative treatments for hot flashes, including selective serotonin reuptake inhibitors (SSRIs). According to a new study published in the Journal of the American Medical Association, treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro) significantly reduces the frequency and severity of menopausal hot flashes compared with placebo.

    Antiepileptic Drugs in Breastfeeding: Neurodevelopmental Outcomes

    Because breastfeeding has many psychological and medical benefits for both the mother and her child, many women would like to breastfeed.  However, all medications taken by the mother are secreted into the breast milk.  While various studies have addressed the safety of antiepileptic drugs (AEDs) in nursing infants, none have systematically assessed the long-term effects of exposure to these drugs on the cognitive development of children exposed to these agents through breastfeeding.  This is an especially important issue as it has been demonstrated that certain AEDs, most notably valproic acid, may negatively affect the developing brain, a process which occurs in utero and into the first few decades of the child’s life.

    Tragedy and Coping

    On Saturday, January 8, a gunman opened fire at a local community event in Tucson, Arizona, targeting U.S. congresswoman Gabrielle Giffords.  Giffords was shot in the head and underwent immediate surgery, and there were a total of at least 18 other victims that were killed or wounded.  The dead included bystanders and colleagues of the congresswoman, including a nine year old girl and a federal judge.  The tragedy unfolded in the midst of the most ordinary of circumstances, a Saturday morning at a neighborhood grocery store, in the context of a casual event in which a political representative made herself available to constituents.  The tragedy quickly stunned and horrified the community of Tucson and the entire country, and received national and international coverage through television, the internet, and other types of media, including social networking.

    American Academy of Pediatrics Recommends Screening for Postpartum Depression

    Postpartum depression is experienced by 10-15% of women and carries risks to both mother and baby.  Untreated maternal depression is associated with negative outcomes for children including behavioral problems, cognitive or developmental delays and impaired attachment.  Treatment of a mother’s depression can improve not only her own functioning and quality of life, but can improve her children’s symptoms as well (Pilowsky 2008).  Given the importance of a mother’s mental health on her baby’s well-being, the American Academy of Pediatrics (AAP) released a recent report which recommends that pediatricians screen mothers for postpartum depression at baby’s one-, two-, and four-month visits (Earls 2010).

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