• Monthly Archives: June 2012

    Outcomes of Children Exposed to Antiepileptic Drugs in Pregnancy: No Good News for Valproate

    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. In addition, recent reports have indicated that in utero exposure to valproate may also result in lower IQ.

    Infertility Treatment is Stressful: But Does Stress Affect the Chances of Getting Pregnant?

    It is common for women experiencing infertility and undergoing fertility treatment to experience significant emotional distress.  Many women, reasoning that their emotional health influences their physical functioning, worry that the stress and anxiety they experience in this context may hinder their ability to become pregnant.

    Yet Another Reason to Take Folate: It Reduces the Risk of Autism

    Women who consume the recommended daily dosage of folic acid (600 mcg) during the first month of pregnancy may have a reduced risk of having a child with autism.  The authors recommend that not only should women who have already conceived take folate,  those who are attempting to conceive should also consider taking folic acid supplements.  

    In Brief: Menopausal Symptoms Usually Go Untreated

    In this study, half of women aged 45 to 60 years reported experiencing menopausal symptoms. 69% of these women reported that their symptoms have negatively  affected their lives. Among the women who endorsed menopausal symptoms, 72% had not received any treatment for their symptoms and 77% reported that they had not discussed treatment options with their healthcare providers.

    From the North American AED Pregnancy Registry: The Newer Anticonvulsants Appear to Be Safer

    While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). The North American AED Pregnancy Registry was established in 1997 for pregnant women in the United States and Canada at the Massachusetts General Hospital. The purpose of the registry is to obtain and publish information on the frequency of major malformations among infants whose mothers have taken one or more AEDs during pregnancy.

    Postpartum Psychosis Can be Prevented in Women at High Risk

    It is well-established that women with a history of bipolar disorder or postpartum psychosis are at extremely high risk of postpartum psychiatric illness. Several studies have indicated that lithium prophylaxis can dramatically reduce the risk of postpartum relapse; however, the studies have varied in terms of the timing of prophylaxis, with some initiating treatment during pregnancy and others initiating treatment immediately after delivery.  A recent study published in the American Journal of Psychiatry gives more information on the clinical management of these high risk populations.

    CBT for the Prevention of Postpartum OCD

    Given the prevalence of postpartum OCD and obsessive symptoms in women with postpartum depression, we should devote more time to this topic.  This is an informative and well-written article by Alice Wolton on postpartum OCD in Forbes.  In this piece, she mentions a recent study from Timpano and colleagues at the University of Miami where cognitive behavioral therapy (CBT) was used to prevent postpartum OCD. 

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