MGH Center for Women's Mental Health

Generalized Anxiety in Pregnancy

Few studies have focused on anxiety disorders in the perinatal period. While various studies have measured levels of anxiety or distress during pregnancy, most studies have relied upon self-report questionnaires to assess for anxiety. In contrast, few studies have used standardized diagnostic criteria to determine the prevalence of anxiety disorders in pregnant populations. In a recent study, Buist and colleagues studied the prevalence and course of generalized anxiety disorder (GAD) in a prospectively ascertained population of pregnant women.

By MGH Center for Women's Mental Health|2015-04-10T13:27:22-04:00June 21st, 2011|Anxiety Disorders, Diagnosis & Screening, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy|Comments Off

Clinical Case: Should SSRIs Be Tapered Prior To Delivery?

Ms. T is a 33 year old woman with a history of recurrent depression who is 32 weeks pregnant with her first pregnancy. She has remained on her citalopram (Celexa) throughout pregnancy and has been well. Her gynecologist has encouraged her to enquire about coming off the Celexa prior to delivery in order to avoid symptoms of neonatal distress. What should she do?

By MGH Center for Women's Mental Health|2015-07-28T14:36:21-04:00June 13th, 2011|Antidepressants, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Postpartum Depression and Poor Sleep Quality Occur Together

In a new mother, sleep is disrupted by repeated awakenings of the infant, but hormonal factors also seem to play a role. Immediately after childbirth, levels of the reproductive hormones, estrogen and progesterone, drop precipitously. It is believed that, because these hormones modulate neurotransmitter systems in the brain responsible for sleep quality, this dramatic hormonal shift may cause significant disruptions in sleep.

By MGH Center for Women's Mental Health|2015-07-28T14:36:07-04:00June 6th, 2011|Depressive Disorders, Postpartum Psychiatric Disorders, Prevalence & Risk Factors, Sleep Disorders|Comments Off

In Utero Exposure to Antipsychotics

May 2011, ObGyn News, Lee S. Cohen, MD

By MGH Center for Women's Mental Health|2020-11-26T08:40:43-04:00May 17th, 2011|Antipsychotic Medications, Outcomes, Pregnancy & Medications|Comments Off

Choice of Antidepressant May Affect Survival in Women on Tamoxifen for Breast Cancer

Tamoxifen is a SERM (selective estrogen receptor modulator) used in women with breast cancer; it reduces the risk of relapse and improves overall survival. Tamoxifen may also be used to reduce the risk of breast cancer in women at high risk for the disease. In order to be fully effective, tamoxifen must be metabolized to an active metabolite, endoxifen, by the liver enzyme CYP2D6. Consequently, any co-administered agent that inhibits this enzyme will reduce the conversion of tamoxifen to endoxifen, thereby potentially reducing the efficacy of tamoxifen as a breast cancer therapy.

By MGH Center for Women's Mental Health|2019-11-03T22:28:44-04:00May 2nd, 2011|Antidepressants, Breast Cancer|Comments Off

Anxiety During Pregnancy: How Does it Affect the Developing Fetal Brain?

During fetal life, neurons proliferate, migrate and form connections, providing the structure of the developing brain. Neurons reach their final destinations by the 16th week of gestation, while branching and making appropriate connections occur even before that time (1). The brain continues to develop during the entire pregnancy, with most of the synapse formation in the developing brain happens during the third trimester (2).

By MGH Center for Women's Mental Health|2016-09-01T11:40:38-04:00April 11th, 2011|Anxiety Disorders, Child Outcomes, Neurodevelopmental Disorders, Psychiatric Disorders During Pregnancy|Comments Off

Cognitive-Behavioral Therapy for Infertile Women: Is it Better than Medication?

Research indicates that women undergoing infertility treatment experience high rates of psychological distress (1). Additionally, it is believed that stress and depression have an impact on fertility, as it has been shown that certain psychological interventions may improve pregnancy rates in infertile women (2-4). In a recent study, Faramarzi and colleagues compared the effects of group cognitive behavioral therapy (CBT), fluoxetine, and no treatment on the mental health of infertile women who had been trying to conceive for at least 2 years (5).

By MGH Center for Women's Mental Health|2015-07-28T14:32:54-04:00April 4th, 2011|Depressive Disorders, Infertility and Mental Health, Medication, Psychotherapy, Treatment|Comments Off

Atomoxetine Improves Memory and Attention in Peri- and Postmenopausal Women

Many peri- and post-menopausal women describe problems with memory and attention. Data regarding the use of estrogen replacement therapy to improve cognitive functioning has been mixed. Furthermore, recent concerns regarding the long-term risks of ERT have limited its use. A recent report from C. Nell Epperson and colleagues from the University Of Pennsylvania School Of Medicine indicates that atomoxetine (Strattera), a treatment for attention-deficit/hyperactivity disorder (ADHD), may improve attention and reduce memory difficulties in perimenopausal and postmenopausal women.

By MGH Center for Women's Mental Health|2015-07-28T14:30:42-04:00March 28th, 2011|Menopausal Symptoms, Treatment|Comments Off

Methadone and Breastfeeding

Up until 2001, the American Academy of Pediatrics (AAP) recommended that methadone was compatible with breastfeeding in women taking less than 20 mg per day. Because most women on methadone maintenance therapy typically require 50 to 15o mg of methadone per day during pregnancy, this meant that most women on methadone were not able to breastfeed. However, the dose restriction for methadone was eliminated in 2001, a decision driven by several studies indicating that the levels of methadone secreted into human breast milk were relatively low.

By MGH Center for Women's Mental Health|2017-05-05T18:31:03-04:00March 21st, 2011|Breastfeeding & Medications, Opioids, Perinatal Substance Use|Comments Off

Making Individual Decisions Regarding the Use of Antidepressants During Pregnancy

Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. This choice can be especially difficult for women taking newer medications which lack adequate reproductive safety data.

By MGH Center for Women's Mental Health|2015-07-28T14:27:36-04:00March 14th, 2011|Antipsychotic Medications, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

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