While we have now a fair amount of information regarding the course of major depression and bipolar disorder during pregnancy and the postpartum period, we have much less information on the course obsessive-compulsive disorder (OCD). [...]
A study to be published in an upcoming issue of Menopause suggests that stellate ganglion blockade (SGB) may be an effective option for women with vasomotor symptoms (VMS), including hot flashes and night sweats. SGB is used primarily for pain management and involves the injection of local anesthetic into the stellate ganglion, part of the sympathetic nerve system located in the neck.
As many as 30% of people suffering from depression do not respond to antidepressant treatment1. When treatment options are exhausted psychiatrists often turn to electroconvulsive therapy (ECT). An electric current is used to cause a brief seizure in the brain. Although this is a relatively safe method of treatment, impairments of both cognition and memory are potential side effects2.
Most studies evaluating the prevalence of perinatal depression are cross-sectional, meaning that depressive symptoms are measured at a single point in time. Less information is available regarding the trajectory of perinatal depression. In obstetric populations, it seems that there are women with briefer episodes of milder postpartum depressive symptoms, while others have more persistent and debilitating depressive symptoms after childbirth. Other women experience depression during pregnancy. Several studies suggest that there is considerable heterogeneity among women who experience depressive symptoms during pregnancy and the postpartum period.
Two recent epidemiologic studies have demonstrated an association between prenatal exposure to selective serotonin reuptake inhibitor antidepressants (SSRIs) with autism spectrum disorders (ASD; Croen et al 2011, Rai et al, 2013). One important imitation of these two studies is that parental psychiatric disorder in itself is associated with an increased risk of ASD in the offspring, and these studies could not distinguish between the effects of drug exposure and the consequences of the underlying maternal psychiatric illness. Two new studies shed light on the association between prenatal antidepressant exposure and risk of autism spectrum disorder in the offspring.
In a recent editorial in The Annals of Internal Medicine entitled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” authors make a case that multivitamins are not a good value (Dec 17, 2013 issue). This editorial was based on new research that demonstrated that there was no association between multivitamin use and rates of mortality, cognitive decline and recurrent cardiovascular events in three different studies. The assertion that multivitamins are not worth the money was widely reported in the media.
Following the publication of the Women's Health Initiative report in 2002, there was a dramatic drop in the use of hormone-replacement therapy (HRT) due to concerns about increased risk of heart disease, breast cancer, and stroke. Since that time, various non-hormonal alternatives have been utilized for the treatment of menopausal symptoms, including gabapentin and various serotonin reuptake inhibitors.
The PPHN story has been a bit of a rollercoaster. Just to review…
Although we do not typically adjust the dosage of medications based on gender, there are certain medications which may have different pharmacokinetics and rates of metabolism in women versus men.
An increasing number of reproductive age women now take newer anticonvulsants for the treatment of mood and anxiety disorders; however, information regarding the reproductive safety of these medications is limited. A recent study has evaluated the cognitive and language development of children born to women with epilepsy exposed in utero to levetiracetam (LEV, Keppra) or sodium valproate (VPA, Depakote), as compared to control children born to women without epilepsy not taking medication during pregnancy.
