This week in the New York Times, there is a two-part story on maternal mental illness. Highlighting the experience of two women who became ill during the postpartum period, the articles focus on the range of disorders which can emerge during the postpartum period -- not only depression, but bipolar disorder, anxiety, OCD, and psychosis.
Many women are understandably concerned about the risk of weight gain associated with antidepressants. It is difficult to advise them as to which antidepressants are less or more likely to cause weight gain, as there [...]
A recent study from researchers at the University of North Carolina reports that the children of depressed mothers treated with selective serotonin reuptake inhibitors (SSRIs) during pregnancy were more likely to develop Chiari type 1 malformations than were the children of mothers with no history of depression.
Many studies have assessed the risk of depression in the mothers of infants, but fewer studies have focused on the risk of depression in the mothers of older children. A recent study published in BJOG [...]
A recent study suggests that physical exercise during pregnancy may reduce depressive symptoms. This study from Spain included 184 healthy pregnant women (31.37 ± 3.62 years). Women randomized to the exercise group (EG) participated in a supervised exercise program consisting of three, 55- to 60-min sessions per week throughout pregnancy. A total of 167 pregnant women were analyzed; 90 in the exercise group and 77 in the control group. Significant differences were found between the two groups at the end of the study in terms of level of depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D): 7.67 ± 6.30 in the exercise group vs. 11.34 ± 9.74 in the control group (p = .005). The percentage of women who were depressed was also lower in the exercise group (12.2%) as compared to the control group (24.7%).
Various selective serotonin reuptake inhibitors (SSRIs), including citalopram (Celexa), escitalopram (Lexapro) and paroxetine (Paxil), have been shown to be effective for the treatment of menopausal vasomotor symptoms (VMS). Other studies have supported the efficacy of the serotonin–norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and venlafaxine (Effexor). The FDA recently approved a 7.5-mg formulation of paroxetine (marketed as Brisdelle) as the first non-hormonal treatment of hot flashes.
According to a policy statement from the American Academy of Pediatrics, all pregnant and breast-feeding women should take a supplement with adequate iodide. It turns out that many American women may be marginally iodine deficient, [...]
While postpartum depression (PPD) affects about 10%-15% of women, most women with PPD do not receive any treatment. Over the last decade, we have made progress in increasing awareness of postpartum mental health issues; however, there are still significant obstacles to obtaining treatment. Women are not able to find appropriate treaters or cannot access care in a timely fashion, especially in more remote areas. They may not have reliable childcare and thus cannot attend their own appointments. Or they may simply be too depressed or anxious to leave their homes.
Many women transitioning into the menopause request medical advice on ways to improve their quality of life and to relieve the symptoms associated with the menopausal transition. With concerns regarding the long-term use of estrogen replacement therapy, there has been interest in the use of non-hormonal strategies to manage these symptoms.
With many states now considering the legalization of medical marijuana, there seems to be a growing sense that marijuana is relatively safe and may, in some cases, be more attractive or effective than traditional pharmacologic interventions. We have witnessed this shift in attitude in our clinic, where many of our clinicians have been surprised to hear women ask questions about the dangers of using antidepressants and other medications during pregnancy while at the same time feeling relatively comfortable with their use of marijuana in the same setting.
