Psychiatric Disorders During Pregnancy - MGH Center for Women's Mental Health

Generalized Anxiety in Pregnancy

Few studies have focused on anxiety disorders in the perinatal period. While various studies have measured levels of anxiety or distress during pregnancy, most studies have relied upon self-report questionnaires to assess for anxiety. In contrast, few studies have used standardized diagnostic criteria to determine the prevalence of anxiety disorders in pregnant populations. In a recent study, Buist and colleagues studied the prevalence and course of generalized anxiety disorder (GAD) in a prospectively ascertained population of pregnant women.

By MGH Center for Women's Mental Health|2015-04-10T13:27:22-04:00June 21st, 2011|Anxiety Disorders, Diagnosis & Screening, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy|Comments Off

Clinical Case: Should SSRIs Be Tapered Prior To Delivery?

Ms. T is a 33 year old woman with a history of recurrent depression who is 32 weeks pregnant with her first pregnancy. She has remained on her citalopram (Celexa) throughout pregnancy and has been well. Her gynecologist has encouraged her to enquire about coming off the Celexa prior to delivery in order to avoid symptoms of neonatal distress. What should she do?

By MGH Center for Women's Mental Health|2015-07-28T14:36:21-04:00June 13th, 2011|Antidepressants, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Anxiety During Pregnancy: How Does it Affect the Developing Fetal Brain?

During fetal life, neurons proliferate, migrate and form connections, providing the structure of the developing brain. Neurons reach their final destinations by the 16th week of gestation, while branching and making appropriate connections occur even before that time (1). The brain continues to develop during the entire pregnancy, with most of the synapse formation in the developing brain happens during the third trimester (2).

By MGH Center for Women's Mental Health|2016-09-01T11:40:38-04:00April 11th, 2011|Anxiety Disorders, Child Outcomes, Neurodevelopmental Disorders, Psychiatric Disorders During Pregnancy|Comments Off

ACOG Focuses on Smoking Cessation in Pregnant and Postpartum Women

In the November issue of Obstetrics & Gynecology, The American College of Obstetricians and Gynecologists (ACOG) has issued recommendations to providers regarding efforts to support smoking cessation in pregnant and postpartum women.

By MGH Center for Women's Mental Health|2017-05-05T11:50:17-04:00November 10th, 2010|Nicotine, Perinatal Substance Use, Postpartum Psychiatric Disorders, Prevention, Psychiatric Disorders During Pregnancy|Comments Off

Insomnia Across the Female Life Cycle

In the July 2010 issue of Current Psychiatry, you will find a thorough review on the evaluation and treatment of insomnia in women across the life cycle. The bottom line is that many women experience insomnia during times of hormonal transition. The authors provide some useful guidelines for evaluating women who present with sleep problems (taken from Table 2):

By Ruta Nonacs, MD PhD|2025-12-11T09:41:06-04:00October 12th, 2010|Menopausal Symptoms, Postpartum Psychiatric Disorders, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy, Sleep Disorders|Comments Off

Discontinuation of Antidepressants: Slower is Better

About half of all pregnancies are unplanned. In this situation, many women who conceive while on psychotropic medications decide to abruptly stop their medications when they discover they are pregnant. While this may seem like the safest option, in terms of protecting the developing fetus, we have data demonstrating high rates of relapse in women who discontinue antidepressant medications or mood stabilizers proximate to conception. We now have data (from several studies in non-pregnant populations) to indicate that the rate of medication discontinuation (abrupt vs. gradual) may also affect risk of relapse.

By MGH Center for Women's Mental Health|2015-08-13T11:01:51-04:00September 13th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Should SSRIs Be Tapered Prior To Delivery?

Increased muscle tone, jitteriness, sleep disturbance, irritability, feeding problems, mild respiratory distress and myoclonus have been reported as symptoms of a potential neonatal distress syndrome related to exposure to SSRIs in late pregnancy. The average duration of symptoms reported is 48 hours. It is estimated that between 25-30% of SSRI-exposed infants are at risk for this syndrome. No treatment intervention is required. Reassuringly, follow-up studies have shown that at 2, 4, 6, and 8 months SSRI-exposed infants are indistinguishable from control infants without known exposure.

By MGH Center for Women's Mental Health|2015-08-12T17:01:53-04:00September 8th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

The Importance of Proper Dosing of Antidepressants during Pregnancy

Pregnancy and the postpartum period is a time of increased risk for depression. Therefore, women who are treated with antidepressant medications must consider whether or not to stay on medication during pregnancy. Despite reassuring data regarding the reproductive safety of various antidepressants, a woman may prefer not to continue medication during pregnancy due to concerns about long term effects of medication on the baby. However, by discontinuing antidepressant medication, a woman increases her risk of depression during pregnancy. This is a highly personal decision for women as the potential risks of continuing medication must be weighed against the possibility of relapse and the potential effects of untreated depression on the pregnancy and baby.

By MGH Center for Women's Mental Health|2015-08-12T16:58:36-04:00August 30th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Non-Pharmacologic Options for the Treatment of Antenatal Depression: A Quick Review

About 15% of women suffer from depression during pregnancy, and the rate of depressive illness is greater in women with pre-existing histories of depression. While there are data to support the use of certain antidepressants during pregnancy, many women are reluctant to seek pharmacologic treatment during pregnancy and may benefit from efficacious non-pharmacologic options. In a recent review article from Medscape, Christopher Tjoa and colleagues from the University of Pennsylvania summarize the literature assessing the efficacy of non-pharmacologic options for the treatment of antenatal depression.

By MGH Center for Women's Mental Health|2015-08-12T16:51:45-04:00July 27th, 2010|Depressive Disorders, Psychiatric Disorders During Pregnancy, Psychotherapy, Treatment|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