An ideal treatment for major depressive disorder (MDD) in women would be efficacious, safe, and offer broad health benefits. MDD is prevalent in women of childbearing years, and recent research underscores the risk of recurrence [...]
The lifetime prevalence rate of obsessive-compulsive disorder (OCD) has been consistently estimated to be 2%-3% in the general adult population throughout the world, making OCD one of more common psychiatric diagnoses; however research on OCD in pregnancy and peurperium has been limited.
Approximately seventy percent of all women experience hot flashes and/or night sweats (also called vasomotor symptoms) during the menopause transition (Stearns et al. 2002). Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes. Since the results of the Women's Health Initiative in 2002 noted risks of prolonged use of hormone therapy in older postmenopausal women (Roussouw et al. 2002), many women pursue other treatments for their hot flashes, including over-the-counter complementary and alternative medicines (CAMs), including soy isoflavones, black cohosh, and omega-3 fatty acids. However, there is limited evidence to support the use of these treatments for hot flashes to date.
While many women who smoke successfully quit smoking during pregnancy, most of these women return to smoking within 12 months of delivery. Several studies have suggested that certain factors may increase the risk of postpartum relapse, including unwanted pregnancy, multiparity, and stressful life events. Two recent studies indicate that postpartum depressive symptoms may also increase the risk of smoking relapse after delivery.
About 15% of women suffer from depression during pregnancy, and many reports have suggested that depression during pregnancy may have negative effects on the fetus.  A new study from researchers at the University of Michigan indicates a link between depression during pregnancy and infant sleep problems.
Significant numbers of reproductive-aged women experience premenstrual syndromes characterized by depressed mood, irritability, mood swings, anxiety or tension, sleep disruption, and other physical symptoms, including bloating and breast tenderness. Typically these symptoms emerge during the week preceding menstruation, improve with the onset of menses, and are not present during the week after menstruation.
Atypical antipsychotics are increasingly used to treat psychiatric disorders such as bipolar disorder or schizophrenia. In spite of the important role they play for many patients in treating serious psychiatric disorders, atypicals have been associated with negative side effects that may worsen a patient's cardiovascular health profile.  This includes a greater risk for weight gain, glucose dysregulation/diabetes, and dyslipidemia (elevated triglycerides/cholesterol).
Over the last several years, a number of studies have indicated that exposure to antidepressants near the time of delivery may be associated with poor neonatal outcomes. A recent prospective study from Dubnov-Raz and colleagues published in the journal Pediatrics found an association between QTc interval prolongation in neonates and antenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants. The QT interval is a measurement of the heart's electrical cycle from ventricular depolarization to the end of ventricular polarization. It is determined from an electrocardiogram (ECG) and is corrected for heart rate.Â
We invite your comments as we post more cases and clinical scenarios to our blog. Treatment decisions in the field of women's mental health are often not straightforward, and we would like to encourage discussion among clinicians on these issues. You are welcome to leave your name, but comments may also be submitted anonymously. Please keep in mind that all comments are reviewed by our staff prior to being posted on the blog; unfortunately we can not respond to any individual health inquiries on the blog or through our website.
As more research is conducted within the field of women's mental health, there are times when recommendations may change depending on the available data.  We will discuss a case here to illustrate this point.
