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Archive | Essential Reads

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Why Are We Still Using Valproic Acid (Depakote) in Women of Childbearing Age?

  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, limbs, and genitals. Prenatal exposure to valproate may also result in […]

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Ovarian Suppression for PMDD: New Study Suggests Long-Term Effectiveness and Tolerability

  PMDD or premenstrual dysphoric disorder has always been a bit of mystery.  We explain that PMDD is triggered by changes in reproductive hormone levels, but when you look at hormone levels in women with PMDD, they do not differ significantly from the hormone levels of women without PMDD.  Another question is why some women […]

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Smoking During Pregnancy Not Associated with Severe Mental Illness in Offspring, But Other Risks Exist

Over the years, we have seen a number of research studies which suggested a link between maternal smoking during pregnancy and adverse psychiatric outcomes in offspring, including increased risk for bipolar disorder, schizophrenia, and attention-deficit/hyperactivity disorder (ADHD).  In a recent article published in JAMA Psychiatry, researchers reported on the results of a population-based cohort study […]

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The Effects of Marijuana on Embryo Development

Given that many states have or are now moving forward with the legalization of medical and recreational marijuana, it should be no surprise that we are seeing an increasing number of women in our clinic who are using marijuana on a regular basis. According to a nationwide survey, 7.3% of Americans 12 or older regularly […]

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Perinatal Depression Screening Is Just The Start

The following post was first published in OB/GYN News. Please see our OB/GYN News archives here. Publish date:  March 3, 2017 Over the last decade, appreciation of the prevalence of perinatal depression – depression during pregnancy and/or the postpartum period – along with interest and willingness to diagnose and to treat these disorders across primary care, obstetric, […]

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Stimulants In Pregnancy and Increased Risk of Gestational Hypertension

  Our group has noted that we are seeing an increase in the number of consultations for women treated with psychostimulants in combination with an antidepressant.  The reasons vary.  Some women have depression and comorbid attention-deficit/hyperactivity disorder (ADHD).  Sometimes a psychostimulant is used to manage residual symptoms and side effects, such as fatigue and cognitive […]

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What Causes Poor Neonatal Adaptation in Antidepressant-Exposed Infants?

It was back in 2005 when we first reported on studies which demonstrated an increased risk of “poor neonatal adaptation” in infants with prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy.  Since that time, reports consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of […]

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How Does Postpartum Anxiety Affect Infants and Young Children?

Many studies have documented the finding that exposure to maternal psychiatric illness early on in the child’s life may adversely affect the child’s cognitive, emotional and behavioral development. These early studies focused on the impact of postpartum depression.  (The effects of PPD on the child are reviewed in Goodman et al, 2011.)  However, we know […]

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