We write often here about the negative effects of postpartum depression on the child. Â Most of the studies thus far have focused on behavior and cognitive development; a recent study from researchers at JohnsHopkinsUniversity suggests that being exposed to maternal depression during the first year of life may negatively affect the physical development of the child as well.
In a recent randomized, single-blind, controlled, clinical trial, 187 postmenopausal women reporting at least 7 hot flashes per day received five weekly sessions of either clinical hypnosis or structured-attention control. Hot flash score were assessed by daily diaries on weeks 2 to 6 and at week 12.
The FDA recently approved a 7.5-mg formulation of the selective serotonin reuptake inhibitor (SSRI) paroxetine mesylate for the treatment of hot flashes.  It will be marketed under the name of Brisdelle.
Postpartum psychosis is a rare but serious psychiatric illness, occurring in about 1 to 2 per 1000 women after delivery. Because postpartum psychosis carries significant risks for both the mother and her child, most women with this illness are psychiatrically hospitalized. Electroconvulsive therapy (ECT) is an effective treatment for postpartum psychosis and may reduce the risks associated with medication exposure in the nursing infant; however, very few research studies have focused on the use of ECT in this setting and it is less commonly used in the United States than in other countries. A recent study explores the safety and advantages of ECT for the treatment of women hospitalized for postpartum psychosis.
We previously reported on studies suggesting estrogen may be helpful for the treatment of depression in peri- and post-menopausal women, either alone or in combination with an antidepressant. In addition, other studies have suggested that older, postmenopausal women may respond more poorly to antidepressants than premenopausal women. Two recent studies attempt to better understand the impact of reproductive hormones on clinical presentation and treatment response of depression in women.
Serotonin reuptake inhibitors (SSRIs) are frequently combined with benzodiazepines for the management of anxiety disorders or major depression with comorbid anxiety. While we have data regarding the reproductive safety of both the SSRIs and benzodiazepines, we have much less information on outcomes in women taking SSRIs and benzodiazepines together. A previous study (Oberlander 2008) found that neither the use of an SSRI alone nor the use of a benzodiazepine alone increased the risk for congenital malformation; however, in this study, the combined use of the two drugs increased the risk of cardiovascular defect. A recent study reassesses the risk of major malformation in women taking SSRIs combined with benzodiazepines.
Iodine is essential for thyroid hormone synthesis. We have known for a long time that severe iodine deficiency during pregnancy may affect the cognitive development of the unborn child. According to a recent Lancet study, even children born to women with mild-to-moderate iodine deficiency during pregnancy are at increased risk for lower IQ and reading ability (assessed at age 9). The most severe effects were observed among children born to women with severe deficiency (<50 mcg/g iodine:creatinine ratio).Â
It is estimated that autism spectrum disorders (ASD) affect about 1% to 2% of children. Research carried out in twins and families indicate that ASD is highly heritable; however, it is generally believed that while genetic factors play an important role, there is an interplay between genetic and environmental factors in the etiology of this disorder. Various environmental exposures have been implicated, including vaccinations, mercury, air pollution, insecticides, and infection.
There have been multiple recent reports indicating that the use of valproate during pregnancy may be associated with lower IQ, cognitive problems, and developmental delays in exposed children. This has prompted the FDA to issue a warning regarding the use of valproate-containing drugs, including Depakote and Depakene, during pregnancy:
Studies assessing the effectiveness of complementary and alternative medicines (CAM) for the treatment of menopause-related hot flashes have yielded conflicting results. Most studies have demonstrated that treatments such as soy and black cohosh are not likely to be effective in most women; however, a new study suggests that women who take higher doses (100 to 200 mg)of isoflavones and more frequent dosing (2-3 times per day) may experience a greater reduction in the frequency of hot flashes.
