Outcomes - MGH Center for Women's Mental Health

Interactions Between Antidepressants and Tamoxifen

Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions with specific antidepressant medications (e.g., SSRI). These antidepressants are used widely to treat depression and anxiety disorders. In addition, multiple studies have shown that these antidepressants are an effective non-hormonal treatment for hot flashes; over 25% of women who are experiencing hot flashes related to tamoxifen therapy are now prescribed antidepressants to manage their symptoms.

By MGH Center for Women's Mental Health|2019-11-03T22:30:23-04:00June 18th, 2008|Antidepressants, Breast Cancer, Outcomes|Comments Off

Melatonin in Pregnancy: Is it Safe?

Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. In a previous post, we discussed the use of different types of medications to treat insomnia during pregnancy. While these drugs are highly effective, many women with sleep problems inquire about the use of "natural" agents, such as melatonin, during pregnancy.

By MGH Center for Women's Mental Health|2017-04-07T09:30:08-04:00May 30th, 2008|Alternative & Complementary, Child Outcomes, Outcomes, Pregnancy & Medications, Risk of Malformations, Sleep Medications|Comments Off

Postpartum Depression in Men Linked to Psychiatric Illness in Their Children

While many studies have looked at the impact of postpartum depression in mothers on their children, there is very limited data on postnatal depression in the fathers and the potential impact it may have on their children.

By MGH Center for Women's Mental Health|2015-08-11T13:27:52-04:00May 26th, 2008|Child Outcomes, Outcomes, Postpartum Depression, Postpartum Psychiatric Disorders|Comments Off

Stress During Pregnancy Increases ADHD Risk

While genetic factors are clearly important in determining a child’s risk for attention deficit hyperactivity disorder (ADHD), recent studies have investigated the link between exposure to certain maternal behaviors during pregnancy, such as smoking and alcohol use, and the risk of developing behavioral problems related to attention deficit hyperactivity disorder in childhood. While multiple studies have indicated a greater risk of ADHD symptoms among children whose mothers smoked during pregnancy, contradictory findings were reported in studies focusing on exposure to alcohol. Results from studies investigating the impact of psychological stress during pregnancy have been inconsistent but suggest a possible contribution to ADHD symptoms int he offspring.

By MGH Center for Women's Mental Health|2015-07-28T10:07:59-04:00May 10th, 2008|Anxiety Disorders, Child Outcomes, Depressive Disorders, Long-Term Outcomes, Neurodevelopmental Disorders, Outcomes, Psychiatric Disorders During Pregnancy, PTSD and Stress Related Disorders|Comments Off

Accumulating Data on Prenatal Exposure to SSRIs

November, 2006 by LEE COHEN, M.D. Over the last year, several studies on possible neonatal effects of prenatal exposure to SSRIs have been reviewed in this column. These studies have raised concerns about potential risks, [...]

By MGH Center for Women's Mental Health|2020-12-11T12:38:11-04:00April 29th, 2008|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

New Study Does Not Find Link Between Paroxetine and Cardiovascular Defects

In 2006, GlaxoSmithKline (GSK) elected to change product label warnings for the antidepressant paroxetine (Paxil), advising against the use of this drug by women who are pregnant. This decision was based on preliminary studies which suggested an increase in the risk of cardiovascular malformations among infants exposed to paroxetine in utero. A recent study from the Motherisk Program in Toronto has reported on the outcomes of over 3000 paroxetine-exposed infants.

By MGH Center for Women's Mental Health|2015-08-11T12:19:14-04:00April 23rd, 2008|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

PPHN and SSRIs: New Findings

Over the past few years, multiple reports have raised questions regarding the safety of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. Chambers and colleagues reported that exposure to SSRIs late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). In the general population, PPHN affects about 1 to 2 per 1000 live births. Infants with PPHN are typically full-term or near-term and present shortly after delivery with severe respiratory distress. In the worst cases, PPHN requires intubation and mechanical ventilation and may result in long-term morbidity. In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn. Based on the results of this analysis, the authors estimated the risk of PPHN to be about 1% in infants exposed to SSRIs late in pregnancy (after 20 weeks).

By MGH Center for Women's Mental Health|2015-08-11T11:42:51-04:00March 31st, 2008|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

SSRIs and Pregnancy: Evaluating New Reproductive Safety Data

Over the past 15 years, multiple studies have addressed the reproductive safety of various antidepressants. Data on the overall teratogenicity of SSRIs has come from relatively small prospective observational studies, larger international birth registries, managed health care databases, and case series; these data have cumulatively supported the reproductive safety of fluoxetine and certain other SSRIs. In a recent meta-analysis including 1774 antidepressant-exposed infants, first trimester exposure to SSRIs was not associated with an increased risk of major malformations above the baseline of 2%-3% seen in the general population (Einarson & Einarson, 2005). The bulk of the data thus far has suggested that SSRIs are not major teratogens; however, concerns about the potential teratogenicity of SSRIs were first raised in 2005 when several preliminary studies suggested that paroxetine may be associated with a small increase in risk of congenital abnormalities.

By MGH Center for Women's Mental Health|2015-08-11T10:55:05-04:00March 31st, 2008|Antidepressants, Outcomes, Pregnancy & Medications|Comments Off

Untreated Maternal Depression: What is the Impact on the Unborn Child?

Depression during pregnancy is common. While concerns have been raised regarding the potential teratogenic and long-term neurobehavioral effects of psychotropic drug use during pregnancy, what is often overlooked is the fact that untreated maternal depression may also put the unborn baby at risk.

By MGH Center for Women's Mental Health|2015-08-11T10:52:05-04:00March 27th, 2008|Anxiety Disorders, Child Outcomes, Depressive Disorders, Outcomes, Psychiatric Disorders During Pregnancy|Comments Off

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|Anti-Epileptic Drugs, Bipolar Disorder, Child Outcomes, Mood Stabilizers, Outcomes, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Risk of Malformations|Comments Off