Earlier this year we reported on a possible association between first trimester exposure to topiramate (Topamax) and increased risk of cleft lip and palate. In a recent study published by the American Journal of Obstetrics and Gynecology, researches drew upon data from two birth defect databases to further delineate the risks associated with topiramate exposure.
Various studies have shown that women with a higher body mass index (BMI) or a higher percent of body fat have more frequent or more severe menopausal symptoms. In a recent study, researchers evaluated the impact of a low-fat diet on vasomotor symptoms in a group of 17,473 postmenopausal women between the ages of 50 and 79.
Each year about 600,000 women in the United States undergo a hysterectomy. Somewhere between 55% and 80% of these women who also have their ovaries removed along with the uterus—a procedure known as oophorectomy. After the removal of the ovaries, menopause follows immediately and is associated with a constellation of symptoms including hot flashes and insomnia, as well as depression and anxiety.Â
Over the past few years, there has been a push to screen women for depression both during pregnancy and the postpartum period. Â Â While there have been various initiatives mandating screening, there remain questions regarding the optimal timing of screening and the best screening tools to use.
Recent reports suggest that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms. Other studies indicate that in folate deficient patients, antidepressants may be less effective or may take longer to take effect. In addition, some clinical trials have shown that folate may have a therapeutic effect on depression, either when taken alone or in combination with an antidepressant.
The National Comorbidity Survey estimates that by the time women reach midlife, approximately 23% have experienced at least one episode of major depression and 30% have been diagnosed with an anxiety disorder. Depression and anxiety disorders are each associated with impaired functioning and lower quality of life (QOL). There is also some data to suggest that, even after a depressive episode resolves, those with a history of a affective illness have a lower quality of life than those without histories of depression, with impairment in social and interpersonal functioning.
Soy-based products have long been touted as a treatment for menopausal symptoms. However, many of the clinical studies measuring the effectiveness of dietary sources of soy isoflavones (e.g., soy beverages, soy powder) for the treatment of menopausal vasomotor symptoms (i.e., hot flushes, night sweats) have been negative. Less is known about the effects of soy on cognition. A large clinical trial suggests that soy may not have any positive effects on cognition in postmenopausal women.
Multiple small studies have demonstrated a link between infertility and psychological distress, reporting high rates of anxiety and depressive symptoms among women with infertility. These studies have evaluated psychiatric symptoms or psychological distress; however, less is known about the prevalence of more significant psychiatric disorders in this population. Â
Multiple studies have demonstrated an increased risk of poor neonatal adaptation associated with exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy. Results in the literature consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaption, including jitteriness, restlessness, increased muscle tone, rapid breathing. These symptoms are transient, resolving spontaneously with no specific medical intervention.
Most women undergoing infertility treatment experience increased anxiety. In a randomized clinical trial, researchers explored the effectiveness of acupuncture in diminishing anxiety in a group of women undergoing IVF. 43 patients undergoing IVF received either active acupuncture (n=22) or sham treatment (n=21).  Women with a history of psychiatric illness and those using antidepressants and/or anxiolytic drugs were excluded from the study.  Anxiety levels were assessed before and after treatment using the Hamilton Anxiety Rating Scale (HAS).Â
