antidepressant - MGH Center for Women's Mental Health

SSRIs and Adverse Pregnancy Outcomes: Why You Can’t Just Read the Abstract

Over the past few years, there have been a large number of studies which have relied on large administrative databases to generate information on the reproductive safety of various medications. One of the strengths of this type of approach is that it provides an opportunity to observe outcomes in a large number of subjects; however, there are certain, very important limitations. A recent study published in the American Journal of Obstetrics and Gynecology helps to understand some of the challenges in interpreting the data generated from these studies.

By MGH Center for Women's Mental Health|2015-08-12T11:48:25-04:00September 20th, 2012|Antidepressants, Outcomes, Pregnancy & Medications|Comments Off

New Research from the CWMH: Escitalopram and Sleep in Midlife Women with Vasomotor Symptoms

Selective serotonin and serotonin-norepinephrine inhibitors (SSRIs and SNRIs) have been shown to be effective for the treatment of hot flashes. However, these agents may carry certain side effects, including sexual side effects and sleep disturbance. These two side effects may be particularly concerning to peri- and postmenopausal women who, in addition to having vasomotor symptoms, are more likely to experience sexual dysfunction and sleep disruption than premenopausal women.

By MGH Center for Women's Mental Health|2018-06-08T09:03:31-04:00August 20th, 2012|Medication, Menopausal Symptoms, Research at CWMH, Sleep Disorders, Treatment|Comments Off

Folic Acid and Risk of Perinatal Depression: Is There an Association?

Recent reports suggest that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms. Other studies indicate that in folate deficient patients, antidepressants may be less effective or may take longer to take effect. In addition, some clinical trials have shown that folate may have a therapeutic effect on depression, either when taken alone or in combination with an antidepressant.

By MGH Center for Women's Mental Health|2015-08-12T12:25:29-04:00July 25th, 2012|Depressive Disorders, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy|Comments Off

Measuring the Effects of Antidepressants versus Untreated Depression on Pregnancy Outcomes

Multiple studies have demonstrated an increased risk of poor neonatal adaptation associated with exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy. Results in the literature consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaption, including jitteriness, restlessness, increased muscle tone, rapid breathing. These symptoms are transient, resolving spontaneously with no specific medical intervention.

By MGH Center for Women's Mental Health|2015-08-12T13:56:55-04:00July 10th, 2012|Depressive Disorders, Outcomes, Psychiatric Disorders During Pregnancy|Comments Off

SSRIs and PPHN: A Review of the Data

In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Since that time, several other reports have been published which have examined the association between SSRI antidepressants and PPHN. Here is a summary of the findings to date:

By MGH Center for Women's Mental Health|2015-08-12T15:21:36-04:00November 10th, 2009|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

Case: Prevention of Mood Episodes When Planning for Pregnancy

Our Perinatal and Reproductive Psychiatry team often discusses clinical cases in Rounds, a confidential forum in which we can get advice and consultation from peers who also work in the area of Women's Mental Health. We discussed a patient's situation recently that highlighted the controversial area about how to prevent mood episodes in a woman planning for pregnancy.

By MGH Center for Women's Mental Health|2015-08-12T14:05:35-04:00March 2nd, 2009|Depressive Disorders, Prevention, Psychiatric Disorders During Pregnancy|Comments Off

SSRIs in Pregnancy and Neonatal Distress Syndrome

Most obstetricians are now familiar with the potential for what has become known as neonatal distress syndrome (or "adaptation" syndrome) following third trimester exposure to SSRIs. Some patients still worry about the possibility of their baby developing neonatal distress syndrome, especially if anything unusual happened during the post-delivery experience of an earlier pregnancy. Women may be concerned about whether and to what degree the medication they were on played a role in their infant's distress and whether to continue that medication during a subsequent pregnancy. The following case may help illustrate the decision-making dilemmas.

By MGH Center for Women's Mental Health|2015-08-12T14:01:29-04:00February 17th, 2009|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

Sildenafil (Viagra) Treatment of Women with Antidepressant-Associated Sexual Dysfunction

While some side effects such as nausea, dizziness, and headaches associated with selective serotonin reuptake inhibitor (SSRI) antidepressants tend to decrease or resolve over time, other side effects such as sexual dysfunction rarely remit spontaneously. Treatment of sexual side effects in women is especially important when about 30-70% of patients taking antidepressants may experience sexual side effects, combined with the fact that women are prescribed antidepressants at rates of 2 to 1 when compared to men.

By MGH Center for Women's Mental Health|2015-08-12T12:23:22-04:00January 6th, 2009|Antidepressants, General, Medication, Sexual Health, Treatment|Comments Off

PPHN and SSRIs: Another Study Evaluating the Risk

In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Based on the results of this analysis, the authors estimated the risk of PPHN to be about 1% in infants exposed to SSRIs late in pregnancy (after 20 weeks). However, subsequent studies did not demonstrate a significant association between PPHN and SSRI usage. A new study, this one relying upon data from the Swedish Medical Birth Register, has observed an elevated risk of PPHN among SSRI-exposed infants.

By MGH Center for Women's Mental Health|2015-08-11T14:44:41-04:00September 16th, 2008|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

New Study Does Not Find Link Between Paroxetine and Cardiovascular Defects

In 2006, GlaxoSmithKline (GSK) elected to change product label warnings for the antidepressant paroxetine (Paxil), advising against the use of this drug by women who are pregnant. This decision was based on preliminary studies which suggested an increase in the risk of cardiovascular malformations among infants exposed to paroxetine in utero. A recent study from the Motherisk Program in Toronto has reported on the outcomes of over 3000 paroxetine-exposed infants.

By MGH Center for Women's Mental Health|2015-08-11T12:19:14-04:00April 23rd, 2008|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off