Phenomenology of Postpartum Psychosis: Preliminary Findings from MGHP3
The MGHP3 study provides key insights into the onset, duration, treatment, and characteristics of postpartum psychosis in a large, diverse cohort.
The MGHP3 study provides key insights into the onset, duration, treatment, and characteristics of postpartum psychosis in a large, diverse cohort.
Based on the findings of two meta-analyses and several large cohort studies, we cannot conclude that cannabis is “safe” for use during pregnancy. Data regarding risk for autism spectrum disorder is mixed.
Because women with bipolar disorder are at high risk for relapse during the postpartum period, we typically recommend that women continue treatment with lithium throughout the postpartum period. While this intervention clearly decreases risk for postpartum psychiatric illness, the use of lithium while breastfeeding presents certain challenges.
Xylazine, a veterinary sedative, has become an increasingly common adulterant in the illicit opioid supply, posing unique risks to pregnant individuals and their developing fetuses.
Prenatal cannabis exposure was associated with deficits in executive function and aggressive behavior; however, there are other important exposures to consider in this study.
In this study with over 4000 infants exposed to gabapentin, the information is reassuring. While we cannot rule out the possibility of a small increase in risk of cardiovascular malformations in gabapentin-exposed infants, gabapentin does not appear to be a major teratogen.
The psychostimulant lisdexamfetamine was well-tolerated and improved both subjective and objective measures of attention and working memory in women undergoing surgical menopause.
With ketamine and esketamine increasingly used to treat depression, especially in women of reproductive age, this study reveals important gaps in care, including inconsistencies in pregnancy testing, informed consent, and contraception practices among ketamine clinics in the United States.
In this large observational study, similar and, in some instances, more favorable neonatal and maternal outcomes were observed in pregnancies exposed to buprenorphine combined with naloxone compared to pregnancies exposed to buprenorphine alone.
Clinically significant anxiety symptoms are common during the postpartum period and frequently complicate the treatment of postpartum depression. While SSRIs are indicted for the treatment anxiety symptoms, especially when they co-occur with depression, many women may need to use a benzodiazepine for managing more severe symptoms of anxiety or insomnia.