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Harvard Medical School

Archive | Psychiatric Disorders During Pregnancy

Maternal Bipolar Disorder Not a Predictor of Infant Developmental Deficits at One Year of Age

  While some women with bipolar disorder elect to discontinue their psychotropic medications during pregnancy to mitigate fetal exposure, Viguera and colleagues (2000, 2007) found that women stabilized on lithium face a significant risk for relapse if they choose to discontinue treatment during pregnancy.  These treatment decisions are difficult and vary on a case-to-case basis, […]

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Why Do Many Continue To Recommend Tapering SSRI Antidepressants During the Third Trimester?

  In 2005, we saw the first reports describing an increased risk of “poor neonatal adaptation” in infants with prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy.  Since that time, studies have consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaptation. […]

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Antenatal Exposure to Antidepressant and Risk of Psychiatric Illness in the Child

  When we provide consultations regarding the use of antidepressants during pregnancy, one of the most difficult questions we have to answer is related to the long-term effects of prenatal antidepressant exposure. Specifically, do antidepressants used by the mother during pregnancy affect the long term development of the fetus?  While many studies have attempted to […]

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Prenatal exposure to benzodiazepines and sibling-controlled cohort study

  Over the last decade, we have seen multiple studies looking at the long term effects of prenatal exposure to antidepressants, particularly the selective serotonin reuptake inhibitors or SSRIs, on children’s behavior.  Although benzodiazepines, such as lorazepam (Ativan) and clonazepam (Klonopin), and sedative-hypnotic medications are used relatively frequently during pregnancy, we have much less information […]

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National Pregnancy Registry for Atypical Antipsychotics Milestone

  We are excited to announce the enrollment of our 1000th participant in the National Pregnancy Registry for Atypical Antipsychotics! Formed in 2008, the Registry was established at MGH to prospectively evaluate the rates of malformations among infants exposed in utero to atypical antipsychotics. Data from the Registry thus far suggest that atypical antipsychotics as […]

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New Research from the CWMH: Patterns of Atypical Antipsychotic Use During Pregnancy

  The use of the newer “atypical” or second-generation antipsychotic agents is increasing.  Atypical antipsychotics are now used to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders.  Using data from the Medicaid Analytic eXtract (MAX) data of pregnant women who delivered infants born between 2001 and […]

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New Study at the CWMH: Course of ADHD During Pregnancy and the Postpartum

  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 […]

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Prescribing Psychotropic Medications with Opioids During Pregnancy May Increase Risk for Neonatal Withdrawal

  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 […]

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Announcing the MGH Perinatal Depression Scale at the App Store

    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 […]

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Clinical Guidelines for Lithium Dosing During Pregnancy

  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 […]

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