Outcomes - MGH Center for Women's Mental Health

Antiepileptic Drugs in Breastfeeding: Neurodevelopmental Outcomes

Because breastfeeding has many psychological and medical benefits for both the mother and her child, many women would like to breastfeed. However, all medications taken by the mother are secreted into the breast milk. While various studies have addressed the safety of antiepileptic drugs (AEDs) in nursing infants, none have systematically assessed the long-term effects of exposure to these drugs on the cognitive development of children exposed to these agents through breastfeeding. This is an especially important issue as it has been demonstrated that certain AEDs, most notably valproic acid, may negatively affect the developing brain, a process which occurs in utero and into the first few decades of the child’s life.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:17-04:00January 24th, 2011|Anti-Epileptic Drugs, Breastfeeding & Medications, Child Outcomes, Neurodevelopmental Disorders, Outcomes|Comments Off

SSRI Use Associated with Reduced Intention to Breastfeed

Given the potential health benefits of breastfeeding on both mother and baby, the U.S. Public Health Service for Healthy People 2010 set a goal to have 75% of mothers breastfeed in the early postpartum period and 50% of mothers to continue breastfeeding to 6 months by the year 2010 (US Dept of Health and Human Services 2000). Groups of women who are less likely to breastfeed have been targeted in this effort.

By MGH Center for Women's Mental Health|2015-08-13T11:37:06-04:00October 26th, 2010|Antidepressants, Breastfeeding & Medications, Outcomes, Postpartum Psychiatric Disorders|Comments Off

Clinical Update 2010: Use of Stimulant Medications in Pregnancy

Approximately 4% of the adult population suffers from ADHD. Attention and executive functioning difficulties also occur in those with mood and psychotic disorders and require treatment strategies similar to those used to address ADHD symptoms. First line medications most often used to treat ADHD in adults are Dextroamphetamine (Dexedrine, Adderall) and Methylphenidate (Concerta, Ritalin, Metadate).

By MGH Center for Women's Mental Health|2017-12-22T13:05:25-04:00September 27th, 2010|ADHD Medications, Outcomes, Pregnancy & Medications|Comments Off

Anxiety During Pregnancy Predicts Worse Outcomes

In treating pregnant women with mood or anxiety disorders, we tend to focus primarily on the reproductive safety of psychotropic medications; however, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may carry some degree of risk. Untreated psychiatric illness in the mother cannot be considered a benign event, and a number of studies have indicated that depression during pregnancy may negatively affect pregnancy outcomes (reviewed in Bonari 2004).

By Ruta Nonacs, MD PhD|2024-03-24T11:56:41-04:00July 14th, 2010|Anxiety Disorders, Outcomes, Pregnancy Outcomes, Psychiatric Disorders During Pregnancy|Comments Off

Depression and Anxiety: Do They Impact Infertility Treatment?

Infertility affects an estimated 10-15% of couples of reproductive age. Several studies have indicated that patients undergoing in vitro fertilization (IVF) experience high levels of stress, depression, and anxiety. Multiple risk factors for anxiety and depression during infertility treatment have been identified; these include being female, age over 30, lower level of education, lack of occupational activity, a male cause for infertility, and infertility for 3-6 years.

By MGH Center for Women's Mental Health|2015-08-12T16:46:54-04:00June 30th, 2010|Anxiety Disorders, Depressive Disorders, Infertility and Mental Health, Outcomes|Comments Off

Antidepressants and Risk of Spontaneous Abortion

Although the last several decades of research have yielded important findings regarding the safety of antidepressants during pregnancy, some areas are still understudied. For example, there are no conclusive results concerning the risk of spontaneous abortions following antidepressant exposure during the first trimester. Several recent meta-analyses, including one from the Motherisk program (Hemels, 2005), have observed an increased risk of spontaneous abortion among women taking antidepressants.

By MGH Center for Women's Mental Health|2015-08-12T16:45:03-04:00June 21st, 2010|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Valproic Acid and the Risk of Major Malformations

Previous studies have indicated that infants exposed to valproic acid in pregnancy are at increased risk for a range of malformations, including neural tube defects. While these studies have shown an association between valproic acid and various malformations, they have been limited in their ability to quantify the risk of certain, less common malformations. To do this, large population-based case–control studies are more appropriate.

By MGH Center for Women's Mental Health|2015-08-12T16:43:09-04:00June 14th, 2010|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Anticonvulsants and Bone Loss

Anticonvulsants are not only used for the treatment of epilepsy but are now used with increasing frequency for the treatment of mood disorders, such as bipolar disorder. Recent studies have indicated that anticonvulsants may negatively affect bone mineral density, as well as increase fracture risk. This seems to be especially common with the older anticonvulsants (e.g., phenobarbital, carbamazepine, phenytoin, and valproate); however, the data regarding lamotrigine and other newer anticonvulsants is much more limited. While bone loss is more often seen with long-term use of these medications, several reports indicate that decreased bone density may also be detected within the first 1-5 years of use.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:18-04:00May 18th, 2010|Anti-Epileptic Drugs, General, Mood Stabilizers, Outcomes|Comments Off

Lithium and Breastfeeding

Bipolar disorder (types I and II) affect up to 5% of the population in the United States. As the onset of this condition typically occurs during or before the reproductive years, the management of bipolar disorder in women is often complicated by pregnancy. There are concerns regarding fetal exposure to medication, the impact of untreated maternal illness, and data demonstrating that women are at increased risk for relapse during the postpartum period.

By MGH Center for Women's Mental Health|2016-03-28T13:23:57-04:00May 12th, 2010|Breastfeeding & Medications, Mood Stabilizers, Outcomes|Comments Off

What’s Safer for Breastfeeding: Lithium or Lamotrigine?

After last week’s post, we received several comments regarding the use of mood stabilizers in breastfeeding women, specifically asking which is safer: lithium or lamotrigine.

By Ruta Nonacs, MD PhD|2025-06-26T09:07:09-04:00May 4th, 2010|Anti-Epileptic Drugs, Breastfeeding & Medications, Mood Stabilizers, Outcomes|Comments Off