Outcomes - MGH Center for Women's Mental Health

Medication Changes During Pregnancy

At our clinic we have the opportunity to see patients at various stages of pregnancy. When we evaluate a patient while she is still in the planning stages, we may recommend changing medications to those that have a better studied safety profile during pregnancy and see how she does on those medications prior to conception. If that same patient came into our clinic for an evaluation, but was already pregnant, we may make different recommendations than if she was in the planning stages.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:23-04:00February 28th, 2008|Anxiety Disorders, Depressive Disorders, Outcomes, Pregnancy & Medications, Psychiatric Disorders During Pregnancy|Comments Off

Link Found Between Anxiety and Preterm Birth

While there have been concerns regarding the reproductive safety of psychotropic medications, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may not always be the safest option. 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|2024-03-24T11:57:46-04:00October 22nd, 2007|Anxiety Disorders, Outcomes, Postpartum Psychiatric Disorders, Pregnancy Outcomes, Psychiatric Disorders During Pregnancy|Comments Off

Panic Attacks in Older Women Linked to Heart Disease

An article published in the October 2007 issue of Archives of General Psychiatry suggests that older women who experience panic attacks may be at increased risk of having a heart attack or stroke and at increased risk of death over the next five years. MGH researcher Jordan W. Smoller, M.D. and colleagues followed 3,369 healthy postmenopausal women as part of the Women’s Health Initiative. Upon entry into the study, participants filled out a questionnaire about the occurrence of panic attacks in the previous six months and were then followed prospectively for an average of 5.3 years to assess risk for cardiovascular disease. About 10 percent of the women reported having a full-blown panic attack in the six months prior to the study.

By MGH Center for Women's Mental Health|2015-07-28T10:28:51-04:00October 2nd, 2007|Anxiety Disorders, Menopausal Symptoms, Outcomes|Comments Off

Use of SSRIs During Pregnancy

Q. I have been taking antidepressants on and off for the last ten years, and I am now planning a pregnancy. I am now on Effexor, and my psychiatrist recommended switching to Prozac and staying on it up until the end of the second trimester. He said that antidepressants should be avoided later on in pregnancy because they may cause problems for the baby at the time of delivery. I am concerned about having to come off my medication for such a long time. In the past, every time I have tried to stop the medication, my depression has come back within a month or so.

By MGH Center for Women's Mental Health|2015-07-28T10:01:52-04:00July 30th, 2006|Anxiety Disorders, Child Outcomes, Depressive Disorders, Outcomes, Pregnancy & Medications|Comments Off

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|Mood Stabilizers, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Use of Paxil during Pregnancy

Q. I have taken Paxil for about six years for depression and obsessive-compulsive disorder. I have tried several times to stop the medication but the symptoms come back within a few weeks of stopping the medication. My husband and I are now planning a pregnancy, and my obstetrician tells me that I cannot take Paxil during pregnancy. Are there any other options?

By MGH Center for Women's Mental Health|2015-07-28T09:53:02-04:00April 24th, 2006|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Withdrawal Symptoms in Newborns Exposed to SSRIs

A recent report suggests that newborns exposed to selective serotonin reuptake inhibitors (SSRI) antidepressants such as Prozac, Zoloft, Celexa and Paxil may be at risk for developing withdrawal symptoms after delivery (Levinson-Castiel 2005). However, the investigators also noted that the symptoms usually disappeared within 48 hours and did not require medical intervention.

By MGH Center for Women's Mental Health|2015-07-28T09:51:11-04:00April 24th, 2006|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

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|Depressive Disorders, Outcomes, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy, Research at CWMH|Comments Off

Reviewing the Safety of SSRI’s in Pregnancy

Over the past 15 years, multiple studies have addressed the reproductive safety of the selective serotonin reuptake inhibitors (SSRIs). Data on the overall teratogenicity of SSRIs come from relatively small cohort studies and larger international programs, and they have cumulatively supported the reproductive safety of fluoxetine (Prozac) and certain other SSRIs. However, several recent studies have raised concerns regarding the use of SSRIs during pregnancy.

By MGH Center for Women's Mental Health|2015-07-23T14:50:24-04:00December 31st, 2005|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Atypical Antipsychotics during Pregnancy: What are the Risks?

Although primarily used to treat schizophrenia and other psychotic disorders, the newer “atypical” antipsychotic agents are now used widely to treat a spectrum of psychiatric disorders, including major depression, bipolar disorder, PTSD and other anxiety disorders. While the reproductive safety of the older typical antipsychotic drugs, such as haloperidol (Haldol) and perphenazine (Trilafon), is supported by data accumulated over the past 40 years, we have far less data on the newer atypical agents: olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), and clozapine (Clozaril).

By MGH Center for Women's Mental Health|2015-07-23T14:10:59-04:00December 30th, 2005|Antipsychotic Medications, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off