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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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Alcohol Use in Pregnancy: Even Low Levels of Alcohol Exposure Associated with Craniofacial Abnormalities

  While different countries may have different attitudes toward the consumption of alcohol during pregnancy, the American Academy of Pediatrics (AAP) has taken a firm stand against the use of alcohol during pregnancy. In the report entitled “Fetal Alcohol Spectrum Disorders,” published in the November 2015 issue of Pediatrics, the AAP identified prenatal exposure to […]

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Oxcarbazepine (Trileptal) and Pregnancy: Do We Have Enough Information?

  Last week in clinical rounds we discussed a case of a woman with bipolar disorder who was planning a pregnancy.  She had a long history of illness, experiencing primarily depressive episodes since her early 20’s.  The only mood stabilizer that seems to have worked for her has been oxcarbazepine (Trileptal) and she is currently […]

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Lamotrigine Reduces Risk for Postpartum Relapse in Women with Bipolar Disorder

Numerous studies have demonstrated that women with histories of bipolar disorder are at high risk for postpartum illness.  Because of this increased risk for relapse during the postpartum period, we typically recommend that women with histories of bipolar disorder continue treatment with a mood stabilizer throughout the postpartum period.  Historically, lithium has been the most […]

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In Unsettling Times: How to Talk to Your Children About Traumatic Events

Earlier this week, a deadly explosion erupted at an arena in Manchester, England, where the American pop singer Ariana Grande was performing.  One of the most horrifying aspects of the Manchester bombing is that this act of terrorism seemed to target women and children.  Among the injured and dead are young women, children and teens, […]

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Pilot Study of Telephone-Delivered Interpersonal Therapy for Women with Postpartum Depression

It is clear that screening for perinatal depression substantially improves detection; however, screening alone does not appear to improve rates of treatment or outcomes.  What we find is that many, if not most, women with perinatal depression do not receive adequate care.  There appear to be many obstacles: stigma associated with mental illness, lack of […]

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