• Monthly Archives: September 2013

    Complementary and Alternative Medicine Therapies for the Treatment of Perinatal Depression: A Review

    In an excellent and thoughtful review article, Kristina Deligiannidis and Marlene Freeman (from the MGH Center for Women’s Mental Health) summarize data on the efficacy of complementary and alternative medicine therapies for the treatment of perinatal depression.  This is one of the most thorough reviews on CAM and provides thoughtful, evidence-based recommendations regarding the use of these treatments for women with perinatal depression.  It is definitely worth tracking down a copy of this review, but if you can’t find it, here is a summary.

    Prenatal Exposure to Antiepileptic Drugs Associated with Worse Developmental Outcomes

    We have previously written about studies which indicate that prenatal exposure to antiepileptic drugs (AEDs), particularly valproic acid, may adversely affect the developing fetus.  Numerous studies have documented long-term effects of antiepileptic exposure on cognitive functioning: prenatal exposure to AEDs has been associated with lower IQs, as well as lower scores on tests of executive functioning, memory, verbal and nonverbal abilities, in children at 6 yeas of age (Meador KJ et al, 2012).  These deficits were the most prominent in children exposed to valproic acid.

    Pregnancy Loss Increases the Risk of Postpartum Psychiatric Illness

    Pregnancy loss may cause great psychological stress for women. How such a loss, whether or not the woman identifies it as a stressor, affects her emotional well-being after the birth of a future child is unknown.  In order to better understand the relationship between pregnancy loss and risk for postpartum psychiatric illness, researchers assessed 192 women at their first-year pediatric well-child care visits in an urban pediatric clinic.  In this group of low income mothers, 49% of the women reported a previous pregnancy loss (miscarriage, stillbirth, or induced abortion).

    Eating Disorders and Their Impact on Pregnancy Outcomes

    Eating disorders are relatively common among women of reproductive age, yet the literature on the effects of maternal eating disorders (ED) on pregnancy outcomes is relatively sparse.  There has been concern that eating disorders may negatively affect gestational weight gain.  Previous studies have demonstrated an association between maternal anorexia nervosa (AN) (both active and past) and lower infant birthweight (as compared to women with no history of ED); however, calculations of the magnitude of this effect have been inconsistent. 

    Brief Screening Tools for Postpartum Depression

    Various screening tools have been used to identify women with postpartum depression (PPD.  The most widely used self-report tools for detection of PPD are the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI) having ten and 21 items, respectively. However, the EPDS and the BDI may be too lengthy to use for quickly screening patients in obstetric, primary care, or pediatric settings.

    More Data on the Use of Atypical Antipsychotics During Pregnancy

    Despite the use of the newer “atypical” antipsychotic agents to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders, three is relatively little data on the reproductive safety of these newer atypical agents.   

    Calcium Less Effective than SSRI for PMDD and Severe PMS

    About 75% of women with regular menstrual cycles report unpleasant physical or psychological symptoms premenstrually. For the majority of women, these symptoms are mild and tolerable. However, some women have more severe and disabling symptoms, or premenstrual dysphoric disorder (PMDD).  Several years ago, a large, multicenter trial of calcium supplementation found that calcium (600 mg twice a day) significantly reduced both the physical and emotional symptoms of PMS; however, it has not been clear whether calcium supplementation might be effective for more severe premenstrual symptoms or PMDD.

    Research from the CWMH: Are Omega-3 Fatty Acids Effective for Menopausal Vasomotor Symptoms?

    Approximately seventy percent of all women experience hot flashes and/or night sweats during the menopause transition (Stearns et al, 2002).  Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes, but today many women are pursuing non-hormonal treatments, including over-the-counter complementary and alternative medicines (CAMs) for the treatment of these symptoms. 

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