Ruta Nonacs, MD PhD - MGH Center for Women's Mental Health

Prenatal Exposure to Antiepileptic Drugs Associated with Worse Developmental Outcomes

We have previously written about studies which indicate that prenatal exposure to antiepileptic drugs (AEDs), particularly valproic acid, may adversely affect the developing fetus. Numerous studies have documented long-term effects of antiepileptic exposure on cognitive functioning: prenatal exposure to AEDs has been associated with lower IQs, as well as lower scores on tests of executive functioning, memory, verbal and nonverbal abilities, in children at 6 yeas of age (Meador KJ et al, 2012). These deficits were the most prominent in children exposed to valproic acid.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:12-04:00September 27th, 2013|Anti-Epileptic Drugs, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

More Data on the Use of Atypical Antipsychotics During Pregnancy

Despite the use of the newer “atypical” antipsychotic agents to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders, three is relatively little data on the reproductive safety of these newer atypical agents.

By Ruta Nonacs, MD PhD|2024-04-14T16:17:26-04:00September 11th, 2013|Antipsychotic Medications, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Prevalence and Trends in the Use of Antipsychotic Medications during Pregnancy

Since their introduction in the 1990s, atypical (second-generation) antipsychotics have replaced typical (first generation) antipsychotics as the first-line treatment for schizophrenia and related psychotic disorders. These drugs are widely used by reproductive age women across many other disease states including bipolar disorder, major depression and anxiety disorders as either primary or adjunctive treatments.

By Ruta Nonacs, MD PhD|2024-04-14T16:17:44-04:00June 10th, 2013|Antipsychotic Medications, Pregnancy & Medications|Comments Off

Exposure to Valproic Acid and Increased Risk of Autism Spectrum Disorders

There have long been concerns regarding the use of the anticonvulsant valproate (Depakote, VPA) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart and other organ systems. Multiple reports have also indicated that in utero exposure to valproate may also negatively affect cognitive development.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:14-04:00March 4th, 2013|Anti-Epileptic Drugs, Autism Spectrum Disorder, Mood Stabilizers, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Screening for Peripartum Anxiety Disorders: What Are the Best Screening Tools?

A significant number of women experience anxiety symptoms during pregnancy, with about 8.5% of women meeting criteria for generalized anxiety disorder. Other anxiety disorders are less common. The estimated prevalence of panic disorder during pregnancy is 1-2%. The estimated prevalence of obsessive-compulsive disorder is 0.2-1.2%. While we use certain tools, including the Edinburgh Postnatal Depression Scale (EPDS) to screen for depression during pregnancy, what are the best tools for indentifying women with clinically significant anxiety symptoms?

By Ruta Nonacs, MD PhD|2025-12-11T09:48:24-04:00February 12th, 2013|Anxiety Disorders, Diagnosis & Screening, Postpartum Psychiatric Disorders, Psychiatric Disorders During Pregnancy|Comments Off

What’s Worse for Pregnancy: Bipolar Disorder or the Medications Used to Treat It?

In studies of pregnant women with unipolar depression, it has been shown that untreated psychiatric illness in the mother may have a negative impact on pregnancy outcomes, influencing the length of gestation and birthweight. There is far less data on pregnancy outcomes in women with bipolar disorder. A recent Swedish study analyzes pregnancy outcomes in treated and untreated women with bipolar disorder and attempts to distinguish between the effects of medication versus the effects of untreated psychiatric illness in the mother.

By Ruta Nonacs, MD PhD|2024-03-24T11:55:47-04:00February 5th, 2013|Bipolar Disorder, Mood Stabilizers, Outcomes, Pregnancy & Medications, Psychiatric Disorders During Pregnancy|Comments Off

Postpartum PTSD As Common As Postpartum Depression

A recent study from McGill University has assessed the prevalence and course of Post-Traumatic Stress Disorder (PTSD) following childbirth. The sample included 308 women who were assessed at four time points: 25-40 weeks gestation, 4-6 weeks postpartum, 3 and 6 months postpartum. Current and prior PTSD were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR).

By Ruta Nonacs, MD PhD|2026-01-11T11:58:15-04:00September 30th, 2012|Depressive Disorders, Postpartum Psychiatric Disorders, Prevalence & Risk Factors, PTSD and Stress Related Disorders|Comments Off

Use of Antipsychotic Medications in Pregnancy Increases Risk of Gestational Diabetes

Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data regarding the reproductive safety of these medications.

By Ruta Nonacs, MD PhD|2024-04-14T16:18:01-04:00July 17th, 2012|Antipsychotic Medications, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Outcomes of Children Exposed to Antiepileptic Drugs in Pregnancy: No Good News for Valproate

There have long been concerns regarding the use of the anticonvulsant valproate (Depakote) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart. In addition, recent reports have indicated that in utero exposure to valproate may also result in lower IQ.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:15-04:00June 26th, 2012|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

From the North American AED Pregnancy Registry: The Newer Anticonvulsants Appear to Be Safer

While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). The North American AED Pregnancy Registry was established in 1997 for pregnant women in the United States and Canada at the Massachusetts General Hospital. The purpose of the registry is to obtain and publish information on the frequency of major malformations among infants whose mothers have taken one or more AEDs during pregnancy.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:16-04:00June 13th, 2012|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Ruta Nonacs

About Ruta Nonacs, MD PhD