2014 was a huge year in the field of Reproductive Psychiatry.  Never before have we seen so many articles published in this specialty.  Much attention has focused on the reproductive safety of psychotropic medication; however, we have seen an increased interest in the mental health of women and a greater appreciation of how psychiatric illness in the mother may affect the entire family, including her unborn child and family.

Here are some of the highlights from 2014:

This year the U.S. Food and Drug Administration (FDA) published a report outlining the new standards for how to present more accurate information regarding the reproductive safety of medications.

FDA Finalizes Guidelines for Pregnancy and Lactation Labeling Information

Over the last few years, we have reported on several studies which have suggested an increased risk of certain types of cardiovascular malformations among children exposed to selective serotonin reuptake inhibitors (SSRIs) during pregnancy.  In a study that included 64,389 women who used antidepressants during the first trimester of pregnancy, researchers observed no substantial increase in the risk of cardiac malformations attributable to antidepressant exposure.

SSRI Antidepressants Not Associated with Cardiovascular Defects

In 2013, we saw several articles suggesting a link between SSRI exposure and increased risk of autism.  This year, another study – using a more sophisticated analysis of large body of data from the Danish Civil Registration System – did not demonstrate a link between prenatal SSRI exposure and risk for autism.

Good News: New Studies Show No Association Between Antidepressants and Risk of Autism

While studies typically focus on the risks of medication exposure, other studies have focused on the risks of untreated psychiatric illness. Several articles reported that PTSD and anxiety symptoms were associated with higher rates of preterm birth.

Anxiety and PTSD Associated with Preterm Birth

PTSD Increases the Risk of Preterm Birth

While atypical antipsychotic medications are commonly used for the treatment of various psychiatric disorders, relatively little data regarding the reproductive safety and long-term neurodevelopmental effects of these medications.  Several studies this year have reported on the outcomes of children exposed to these newer antipsychotic medications; however, our data remains limited and the The National Pregnancy Registry for Atypical Antipsychotics will continue to evaluate the safety of atypical antipsychotic medications taken by women during pregnancy.

Antipsychotics and Pregnancy Part 1: Preliminary Data from the Australian Registry

Antipsychotics and Pregnancy Part 2: Preliminary Data from the MGH Pregnancy Registry

Other studies have yielded more information regarding the use of psychotropic medications, including the antidepressant bupropion (Wellbutrin), benzodiazepines, and stimulants.

Wellbutrin (Bupropion) Exposure and Risk of Cardiac Malformations

New Data on Anxiety Medications and Pregnancy

Clinical Update: Use of Methylphenidate During Pregnancy

Despite a growing number of studies which support the reproductive safety of antidepressants and other psychotropic medications, we continue to see articles in the press that misrepresent the risks associated with medication exposure and often cause unnecessary anxiety or, at worst, misguided decisions regarding much needed treatment.  Our most widely read post in 2014 addressed the comments made in an article published in the New York Times.

Response to the New York Times Article on SSRIs and Pregnancy: Moving Toward a More Balanced View of Risk

For 2015, our goal is to reach even more readers.  In order to better disseminate information, we are stepping out into the world of social media:

Follow us on Twitter @wmnmentalhealth

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And a Happy and Healthy New Year to all of our readers!

Ruta Nonacs, MD PhD




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