For women with mild to moderate attention-deficit/hyperactivity disorder (ADHD) symptoms, we frequently recommend discontinuing medication and switching to a non-pharmacologic intervention. Although these women might experience some decrease in their level of functioning, they typically [...]
In a recent editorial in The Annals of Internal Medicine entitled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” authors make a case that multivitamins are not a good value (Dec 17, 2013 issue). This editorial was based on new research that demonstrated that there was no association between multivitamin use and rates of mortality, cognitive decline and recurrent cardiovascular events in three different studies. The assertion that multivitamins are not worth the money was widely reported in the media.
While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). A new report from the U.K. and Ireland Epilepsy and Pregnancy Registers suggests that the risk of malformations associated with levetiracetam (LVT, Keppra) use during pregnancy is low.
Previous studies have suggested a link between opioid exposure and increased risk of certain congenital malformations.
Despite the use of the newer “atypical” antipsychotic agents to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders, three is relatively little data on the reproductive safety of these newer atypical agents.
There have been multiple recent reports indicating that the use of valproate during pregnancy may be associated with lower IQ, cognitive problems, and developmental delays in exposed children. This has prompted the FDA to issue a warning regarding the use of valproate-containing drugs, including Depakote and Depakene, during pregnancy:
Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data regarding the reproductive safety and long-term neurodevelopmental effects of these medications. A recent study assessed the development of 76 infants with fetal exposure to atypical antipsychotics.
Despite the fact that gabapentin (Neurontin) is now used in a wide variety of clinical settings -- for epilepsy, pain management, anxiety, sleep disturbance – there is relatively little information regarding its reproductive safety. A prospective study from researchers at the Motherisk program reports on the outcomes of 223 pregnancies exposed to gabapentin and 223 unexposed pregnancies.
Prozac hit the market in 1988, the first selective serotonin reuptake inhibitor (SSRI) antidepressant approved by the FDA for the treatment of depression. Because it was safer and more tolerable than the antidepressants that preceded it, Prozac was soon the most commonly prescribed antidepressant in the United States.
Duloxetine (sold in the United Sates under the brand name of Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) effective for major depressive disorder and generalized anxiety disorder (GAD). Although used fairly commonly in women of child-bearing age, information regarding its reproductive safety has been lacking.
