MGH Center for Women's Mental Health

Duloxetine for the Treatment of Menopausal Symptoms and Mood in Postmenopausal Women

Depression is common in postmenopausal women suffering from menopausal vasomotor symptoms (hot flushes, night sweats) and insomnia. While estrogen replacement therapy may alleviate these symptoms and may also have a positive impact on mood, the use of estrogen has declined over recent years. There has been great interest in finding alternative strategies for the management of menopausal symptoms, and recent data suggest that selective serotonin reuptake inhibitor antidepressants (SSRIs) and the serotonin norepinephrine reuptake inhibitor (SNRI), venlafaxine, may be effective for the treatment of depression and vasomotor symptoms in peri- and postmenopausal women. In a study presented at the annual meeting of the American Psychiatric Association, Dr. Hadine Joffe and her colleagues at the Center of Women’s Mental Health presented data on the use of duloxetine (Cymbalta), a new SNRI, for the treatment of mood, vasomotor symptoms, and insomnia in postmenopausal women.

By MGH Center for Women's Mental Health|2015-07-28T10:00:40-04:00July 30th, 2006|Depressive Disorders, Medication, Menopausal Symptoms, Treatment, Vasomotor Symptoms|Comments Off

Neurobehavioral Outcomes in Children Exposed to Lithium in Utero

Driven by concerns regarding fetal exposure to psychotropic medications, many women with psychiatric illness attempt to discontinue their pharmacologic treatment during pregnancy; however, recent studies indicate that this approach may not be appropriate for all women. Dr. Adele Viguera and her colleagues at the Center for Women’s Mental Health have reported that among pregnant women with bipolar disorder, relapse rates were very high (58%) in women who discontinued maintenance treatment with lithium during pregnancy (Viguera et al 2000). Given this risk of recurrent illness, many women may consider continuing lithium treatment during pregnancy. While the teratogenic effects of first trimester exposure to lithium have been well studied, data on the long-term outcome of children exposed to lithium during pregnancy are sparse. At the 61st Annual Meeting of the Society of Biological Psychiatry in Toronto, Dr. Viguera presented preliminary data on the neurobehavioral outcomes of children exposed to lithium in utero.

By MGH Center for Women's Mental Health|2016-03-28T13:23:59-04:00July 30th, 2006|Mood Stabilizers, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Menstrual Cycle Irregularity in Women with Bipolar Disorder

Preliminary reports have suggested that menstrual irregularity may occur more commonly in women with mood disorders than in the general population. What has been unclear, however, is whether these menstrual cycle irregularities reflect an underlying disruption of the hypothalamic-pituitary-gonadal (HPG) axis in women with mood disorders or are caused by the psychotropic medications used to treat these psychiatric disorders.In a recent study, Dr. Hadine Joffe of the Center for Women’s Mental Health and her colleagues assessed the prevalence of menstrual cycle dysfunction in 3 groups of women: (1) with bipolar disorder, (2) with unipolar depression, or (3) with no psychiatric illness (Joffe 2006).

By MGH Center for Women's Mental Health|2015-07-28T09:54:19-04:00April 24th, 2006|Bipolar Disorder, General|Comments Off

Use of Paxil during Pregnancy

Q. I have taken Paxil for about six years for depression and obsessive-compulsive disorder. I have tried several times to stop the medication but the symptoms come back within a few weeks of stopping the medication. My husband and I are now planning a pregnancy, and my obstetrician tells me that I cannot take Paxil during pregnancy. Are there any other options?

By MGH Center for Women's Mental Health|2015-07-28T09:53:02-04:00April 24th, 2006|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Withdrawal Symptoms in Newborns Exposed to SSRIs

A recent report suggests that newborns exposed to selective serotonin reuptake inhibitors (SSRI) antidepressants such as Prozac, Zoloft, Celexa and Paxil may be at risk for developing withdrawal symptoms after delivery (Levinson-Castiel 2005). However, the investigators also noted that the symptoms usually disappeared within 48 hours and did not require medical intervention.

By MGH Center for Women's Mental Health|2015-07-28T09:51:11-04:00April 24th, 2006|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

SSRIs and Persistent Pulmonary Hypertension of the Newborn

These findings are likely to generate significant anxiety among child-bearing women who suffer from depression who would like to maintain antidepressant medication during pregnancy. Future studies are needed to better understand the risk of PPHN in this setting.

By MGH Center for Women's Mental Health|2025-07-26T08:55:25-04:00April 24th, 2006|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off

New Research from the CWMH: Relapse of Major Depression during Pregnancy

Over the last decade, the number of reproductive-age women treated for depression has increased significantly. Given the incomplete information available regarding the reproductive safety of many antidepressant medications, many women choose to discontinue pharmacologic treatment during pregnancy. However, several studies estimate that about 10 to 15% of women suffer from depression during pregnancy (O'Hara et al, 1990; Evans et al, 2001). A recent study from the Center for Women's Mental Health indicates that the risk for depression is particularly high among women with histories of major depression (Cohen et al, 2006).

By MGH Center for Women's Mental Health|2020-11-26T08:41:14-04:00April 22nd, 2006|Depressive Disorders, Outcomes, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy, Research at CWMH|Comments Off

SSRIs and Neonatal Outcomes: A Population-Based Study from Finland

Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for "toxicity" in newborns exposed to antidepressants around the time of labor and delivery. Several recent studies have suggested that exposure to SSRIs at the time of delivery may be associated with poor perinatal outcomes (Casper 2003, Laine 2003, Simon 2002, Zeskind and Stephens 2004) and prompted the FDA to include warnings in the packaging inserts regarding the use of certain antidepressants, including the selective serotonin reuptake inhibitors (SSRIs) and venlafaxine (Effexor), during pregnancy. These studies have been reviewed previously on the CWMH website (Newsletters Fall 2004 and Spring 2005).

By MGH Center for Women's Mental Health|2015-07-23T14:51:24-04:00January 24th, 2006|Antidepressants, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Reviewing the Safety of SSRI’s in Pregnancy

Over the past 15 years, multiple studies have addressed the reproductive safety of the selective serotonin reuptake inhibitors (SSRIs). Data on the overall teratogenicity of SSRIs come from relatively small cohort studies and larger international programs, and they have cumulatively supported the reproductive safety of fluoxetine (Prozac) and certain other SSRIs. However, several recent studies have raised concerns regarding the use of SSRIs during pregnancy.

By MGH Center for Women's Mental Health|2015-07-23T14:50:24-04:00December 31st, 2005|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Escitalopram for Menopause-Related Depression and Vasomotor Symptoms

Every year more than 1.7 million women in the United States enter into menopause. During this time of hormonal fluctuations it is typical for women to experience hot flashes, night sweats and sleep disturbance. More recently, studies have identified an association between menopausal transition and an increased risk for developing depressive symptoms (Harlow et al., 2003; Freeman et al., 2004). It is not clear how physicians and patients should deal with menopause-related physical and emotional symptoms. While hormone therapy effectively treats insomnia and hot flashes, the results have been mixed in treating mood and anxiety symptoms. Moreover, the safety of long-term use of hormone therapy is not known.

By MGH Center for Women's Mental Health|2015-07-23T14:19:33-04:00December 30th, 2005|Depressive Disorders, Medication, Menopausal Symptoms, Treatment, Vasomotor Symptoms|Comments Off

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