About 1.4 million people in the U.S. have been diagnosed with ADHD, and about 60-80% of children diagnosed with ADHD will need to take their medication into adulthood. When girls diagnosed in childhood become reproductive-aged women, they face challenging decisions regarding how to proceed with their treatment when they are also family planning. There […]
Illicit opioid use has steadily increased over the past decade, and this increase is most prominent in the 18–25 age group, which includes women of reproductive age (Substance Abuse and Mental Health Services Administration, 2013). Paralleling this increase in illicit opiate use in this population has been a significant increase in the use of […]
We are very pleased to announce the release of the MGH Perinatal Depression Scale available free of charge on the App Store (https://appsto.re/us/-3X4jb.i). The MGHPDS smartphone app includes digital versions of perinatal depression screening tools including the Edinburgh Postpartum Depression Scale (EPDS) as well as other instruments which measure relevant symptoms associated with […]
We have an abundance of articles which address the impact of psychotropic medications on pregnancy. Much less research, however, has focused on how pregnancy may affect how these medications work. Physiologic changes take place during pregnancy which may affect the absorption, distribution, metabolism, and elimination of medications. These pharmacokinetic changes may result in lower […]
We have long been interested in understanding the effects of prenatal exposure to antidepressants on the development of the fetal brain. The earliest studies addressing this question were small but yielded detailed (and reassuring) information regarding the cognitive development of children exposed to antidepressants in utero. The findings of these studies supported the hypothesis that […]
The following post was first published in OB/GYN News. Please see our OB/GYN News archives here. Publish date: July 3, 2017 Over the last 2 decades, there has been a growing interest in establishing a rich evidence base for treatment of psychiatric illness in pregnancy and the postpartum period. It seems as if a week does […]
While we use lithium less commonly now than we have in the past, lithium is still one of the very best mood stabilizers we have. And with regard to its reproductive safety, we have studies going back nearly 50 years. In the 1970s, reports from the International Register of Lithium Babies suggested a […]
Last week in clinical rounds we discussed a case of a woman with bipolar disorder who was planning a pregnancy. She had a long history of illness, experiencing primarily depressive episodes since her early 20’s. The only mood stabilizer that seems to have worked for her has been oxcarbazepine (Trileptal) and she is currently […]
In the field of reproductive psychiatry, we don’t really have any textbooks to rely on. However, the June issue of the Psychiatric Clinics of North America is devoted to Women’s Mental Health, and it’s pretty much the most comprehensive guide on this topic. With articles from leaders in the field, it covers PMDD, medication use […]
Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree of teratogenic risk. In contrast, lamotrigine (Lamictal) appears to be a much safer option for […]
