New Research - MGH Center for Women's Mental Health

New England Journal of Medicine Case Report: Postpartum Psychosis in a Woman with Bipolar Disorder

The most recent issue of the New England Journal of Medicine includes the presentation of a case from the Center for Women's Mental Health of a woman with bipolar disorder who developed postpartum psychosis after the birth of her child. The case highlights some of the clinical challenges in treating patients with bipolar disorder during pregnancy and the postpartum period and reviews the current literature on postpartum psychosis.

By MGH Center for Women's Mental Health|2016-03-28T13:23:59-04:00August 11th, 2008|New Research, Postpartum Psychiatric Disorders|0 Comments

Bipolar Disorder and Pregnancy: Should Medications Be Discontinued?

As many of the traditional mood stabilizers used to treat bipolar disorder, including lithium and valproic acid, carry some teratogenic risk and the reproductive safety of other medications, including the atypical antipsychotic agents, has not been well-characterized, many women with bipolar disorder decide to discontinue their treatment during pregnancy. A new study from Dr. Adele Viguera and her colleagues at the Massachusetts General Hospital and the Emory University School of Medicine helps to better define the risks associated with discontinuing treatment during pregnancy.

By MGH Center for Women's Mental Health|2016-03-28T13:38:38-04:00March 7th, 2008|New Research, Psychiatric Disorders During Pregnancy|6 Comments

Perimenopause May Be a Time of Risk for New Onset Depression

The transition to menopause has typically been considered a time when women may be more vulnerable to mood changes. There have been inconclusive data, however, as to whether women with no lifetime history of depression transitioning to menopause are at increased risk for developing an episode of major depression.

By MGH Center for Women's Mental Health|2018-07-11T13:57:12-04:00February 10th, 2007|Menopausal Symptoms, New Research|0 Comments

Neurobehavioral Outcomes in Children Exposed to Lithium in Utero

Driven by concerns regarding fetal exposure to psychotropic medications, many women with psychiatric illness attempt to discontinue their pharmacologic treatment during pregnancy; however, recent studies indicate that this approach may not be appropriate for all women. Dr. Adele Viguera and her colleagues at the Center for Women’s Mental Health have reported that among pregnant women with bipolar disorder, relapse rates were very high (58%) in women who discontinued maintenance treatment with lithium during pregnancy (Viguera et al 2000). Given this risk of recurrent illness, many women may consider continuing lithium treatment during pregnancy. While the teratogenic effects of first trimester exposure to lithium have been well studied, data on the long-term outcome of children exposed to lithium during pregnancy are sparse. At the 61st Annual Meeting of the Society of Biological Psychiatry in Toronto, Dr. Viguera presented preliminary data on the neurobehavioral outcomes of children exposed to lithium in utero.

By MGH Center for Women's Mental Health|2016-03-28T13:23:59-04:00July 30th, 2006|New Research, Psychiatric Disorders During Pregnancy|0 Comments

New Research from the CWMH: Relapse of Major Depression during Pregnancy

Over the last decade, the number of reproductive-age women treated for depression has increased significantly. Given the incomplete information available regarding the reproductive safety of many antidepressant medications, many women choose to discontinue pharmacologic treatment during pregnancy. However, several studies estimate that about 10 to 15% of women suffer from depression during pregnancy (O'Hara et al, 1990; Evans et al, 2001). A recent study from the Center for Women's Mental Health indicates that the risk for depression is particularly high among women with histories of major depression (Cohen et al, 2006).

By MGH Center for Women's Mental Health|2020-11-26T08:41:14-04:00April 22nd, 2006|New Research, Psychiatric Disorders During Pregnancy|0 Comments

Can Women Taking Lithium Breastfeed Their Infants?

It is clear that women with bipolar disorder are at high risk for relapse during the immediate postpartum period (Viguera 2000). There is evidence that the resumption of lithium prior to or within 24-48 hours of delivery can significantly reduce the risk of postpartum illness (Cohen 1995). While this intervention is the current standard of care for this high risk population, women have historically been instructed to avoid breastfeeding while taking lithium based on early reports suggesting high levels of lithium in the breast milk and several cases of lithium toxicity in nursing infants (Schou 1973). While the American Academy of Pediatrics guidelines are less restrictive in their current recommendation, they do urge caution. However, systematic studies regarding the levels of exposure to lithium in nursing infants and the potential risks of this exposure have been lacking.

By MGH Center for Women's Mental Health|2018-07-11T14:35:47-04:00June 14th, 2005|Breastfeeding and Psychiatric Medications, New Research|1 Comment

Oral Contraceptives for the Treatment of Premenstrual Mood Symptoms in Women with Depression

About 3-5% of women of reproductive age suffer from premenstrual dysphoric disorder (PMDD), where they experience depressive symptoms, anxiety or irritability during the last one to two weeks (the premenstrual phase) of their menstrual cycle. In addition, many women who suffer from depression, including those who have been effectively treated with an antidepressant, report worsening of their depressive symptoms during the premenstrual phase of the menstrual cycle. Although this may be a consequence of sensitivity to fluctuating hormone levels, little is known about the efficacy of hormonal interventions, including oral contraceptives (OCPs), in the treatment of premenstrual worsening of depressive symptoms.

By MGH Center for Women's Mental Health|2016-03-28T13:51:33-04:00June 14th, 2005|New Research, PMS and PMDD|0 Comments

Venlafaxine for Postpartum Depression

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) sertraline, fluoxetine, and fluvoxamine for the treatment of this disorder. In a recent report, Cohen and colleagues have demonstrated the efficacy of venlafaxine for the treatment of PPD.

By MGH Center for Women's Mental Health|2016-03-28T13:24:00-04:00February 20th, 2002|New Research, Postpartum Psychiatric Disorders|2 Comments

Bipolar Disorder and Pregnancy

Unfortunately the mood stabilizers most commonly used to treat bipolar disorder (including lithium and valproic acid) can increase the risk of certain types of birth defects or congenital malformations in children exposed to these medications during the first trimester of pregnancy. For this reason, many women with bipolar disorder choose to discontinue maintenance treatment during pregnancy. However, we have observed very high rates of illness during pregnancy among these women who discontinue treatment; over half of the women relapse, most frequently during the first trimester.

By MGH Center for Women's Mental Health|2016-03-28T13:38:39-04:00January 6th, 2001|New Research, Psychiatric Disorders During Pregnancy|1 Comment