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Maternal Bipolar Disorder Not a Predictor of Infant Developmental Deficits at One Year of Age

  While some women with bipolar disorder elect to discontinue their psychotropic medications during pregnancy to mitigate fetal exposure, Viguera and colleagues (2000, 2007) found that women stabilized on lithium face a significant risk for relapse if they choose to discontinue treatment during pregnancy.  These treatment decisions are difficult and vary on a case-to-case basis, […]

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In Brief: Folate Supplements During Pregnancy Reduce Risk of Autism  

  Mothers exposed to household or agricultural pesticides immediately before and during their pregnancies have a higher risk of having a child with autism spectrum disorder (ASD).  However, a recent study from California indicates that taking high-dose folic acid cuts this risk in half, as compared to women who received lower doses of folic acid. […]

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ACOG Releases Revised Guidelines for Treatment of Opioid Use During Pregnancy

We have been writing over the last few years about the growing problem of opioid use and abuse in women of reproductive age.  Responding to a dramatic increase in the number of women abusing opiates during pregnancy, the American College of Obstetricians and Gynecologists (ACOG) has released revised guidelines on the treatment of opioid use […]

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In Brief: Hormone Replacement Has No Impact on Mortality in Women

While there have been concerns regarding the risks associated with prolonged use of hormone replacement, an increasing number of studies suggest that the risk may be relatively low in certain populations and that hormone replacement is appropriate in certain settings.  A recent study published in JAMA has focused on mortality rates in women treated with […]

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The Etiology of Premenstrual Dysphoric Disorder: 5 Interwoven Pieces

The following post was first published in Current Psychiatry, published September 2017, Vol. 16, No. 9, p. 20-28. Check out the article on Current Psychiatry or listen to Dr. Raffi discuss treatment of menstrual–related mood and anxiety disorders. By Edwin R. Raffi, MD, MPH, & Marlene P. Freeman, MD In an age when psychiatry strives to identify […]

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Antenatal Exposure to Antidepressant and Risk of Psychiatric Illness in the Child

  When we provide consultations regarding the use of antidepressants during pregnancy, one of the most difficult questions we have to answer is related to the long-term effects of prenatal antidepressant exposure. Specifically, do antidepressants used by the mother during pregnancy affect the long term development of the fetus?  While many studies have attempted to […]

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Estrogen Receptor Modulator Raloxifene for Women with Schizophrenia

  Several years ago, we reviewed a paper suggesting that estrogen may have beneficial effects for women with schizophrenia.  In this study, women with schizophrenia were treated with estrogen in addition to their antipsychotic medications.  Adjunctive treatment with estrogen was associated with significant improvement in their positive symptoms (hallucinations, delusions), but the women experienced no […]

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Maternal Smoking During Pregnancy Associated with Psychiatric Illness in Offspring

  In the United States, the prevalence of smoking in pregnant women has declined; however, according to data gathered from 29 states by the Pregnancy Risk Assessment Monitoring System (PRAMS), about 13% of women smoked during the last 3 months of pregnancy.  The prevalence varied according to state, with the highest rates reported in West […]

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Clinical Guidelines for Lithium Dosing During Pregnancy

  We have an abundance of articles which address the impact of psychotropic medications on pregnancy.  Much less research, however, has focused on how pregnancy may affect how these medications work. Physiologic changes take place during pregnancy which may affect the absorption, distribution, metabolism, and elimination of medications.  These pharmacokinetic changes may result in lower […]

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Is Psychiatric Illness a Risk Factor for Hyperemesis Gravidarum?

  While the majority of pregnant women experience nausea and/or vomiting during the first trimester of pregnancy, a smaller subset of women — around 1% — experience more severe and intractable vomiting, or hyperemesis gravidarum (HG).  If left untreated, prolonged hyperemesis can lead to weight loss, dehydration, nutrient deficiencies and electrolyte disturbances.   We do […]

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