antidepressants - MGH Center for Women's Mental Health

Premenstrual Syndromes: What is the Optimal Duration of Treatment?

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) affect a large number of women of childbearing age. 30-80% of reproductive age women experience premenstrual symptoms. PMS refers to a pattern of physical, emotional, and behavioral symptoms occurring 1-2 weeks before menses and remitting with the onset of menses. Common symptoms include fatigue, poor concentration, mild mood changes, headaches, abdominal bloating, and breast tenderness.

By MGH Center for Women's Mental Health|2015-08-12T15:32:28-04:00December 21st, 2009|Medication, PMS & PMDD, Treatment|Comments Off

Paroxetine (Paxil) May Affect Sperm Quality

Within the field of psychiatry, there is a growing body of literature studying the use of antidepressants in women in the context of pregnancy and the postpartum period. However, much less attention has focused on the impact of these drugs on fertility, particularly in men. Because major depressive disorders affect about one in 10 American men over their lifetimes, it is essential to study the effects of antidepressants on male fertility.

By MGH Center for Women's Mental Health|2015-07-28T13:31:57-04:00October 1st, 2009|Infertility and Mental Health, Sexual Health|Comments Off

Generic Medications

Many patients ask questions about generic medications, wondering how they differ and if they’re as safe and as effective as the more expensive brand name versions. To better understand this concept, we’ll discuss an example.

By MGH Center for Women's Mental Health|2015-08-12T14:56:26-04:00August 10th, 2009|Antidepressants, General, Medication|Comments Off

Mental Health Parity in Massachusetts

Recent changes expanded the scope of mental health parity in the Commonwealth of Massachusetts, which requires insurance companies to cover specified diagnoses on a “nondiscriminatory basis”. This means that copayments, deductibles, coinsurance, unit of service limits- such as hospital days and outpatient visits, and/or annual or lifetime maximums are no greater for mental disorders when compared to physical conditions.

By MGH Center for Women's Mental Health|2015-08-12T14:51:49-04:00July 16th, 2009|Advocacy, General|Comments Off

Antenatal Use of SSRIs and QT Interval Prolongation in Newborns

Over the last several years, a number of studies have indicated that exposure to antidepressants near the time of delivery may be associated with poor neonatal outcomes. A recent prospective study from Dubnov-Raz and colleagues published in the journal Pediatrics found an association between QTc interval prolongation in neonates and antenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants. The QT interval is a measurement of the heart's electrical cycle from ventricular depolarization to the end of ventricular polarization. It is determined from an electrocardiogram (ECG) and is corrected for heart rate.

By MGH Center for Women's Mental Health|2015-08-12T14:14:31-04:00March 24th, 2009|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

Using New Research to Inform Treatment Decisions during Pregnancy: A Case Report

As more research is conducted within the field of women's mental health, there are times when recommendations may change depending on the available data. We will discuss a case here to illustrate this point.

By MGH Center for Women's Mental Health|2015-08-12T14:09:25-04:00March 17th, 2009|Anxiety Disorders, Bipolar Disorder, Depressive Disorders, Medication, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Grapefruit Juice May Affect Drug Absorption

CYP3A4 is an intestinal enzyme that is part of the Cytochrome P450 metabolic system. It is important in many drug-drug and drug-food interactions, and it is one of the first enzymes to break down medications when they enter the body.

By MGH Center for Women's Mental Health|2015-08-12T12:31:07-04:00February 2nd, 2009|Antidepressants, Antipsychotic Medications, General|Comments Off

Stress During Pregnancy Increases ADHD Risk

While genetic factors are clearly important in determining a child’s risk for attention deficit hyperactivity disorder (ADHD), recent studies have investigated the link between exposure to certain maternal behaviors during pregnancy, such as smoking and alcohol use, and the risk of developing behavioral problems related to attention deficit hyperactivity disorder in childhood. While multiple studies have indicated a greater risk of ADHD symptoms among children whose mothers smoked during pregnancy, contradictory findings were reported in studies focusing on exposure to alcohol. Results from studies investigating the impact of psychological stress during pregnancy have been inconsistent but suggest a possible contribution to ADHD symptoms int he offspring.

By MGH Center for Women's Mental Health|2015-07-28T10:07:59-04:00May 10th, 2008|Anxiety Disorders, Child Outcomes, Depressive Disorders, Long-Term Outcomes, Neurodevelopmental Disorders, Outcomes, Psychiatric Disorders During Pregnancy, PTSD and Stress Related Disorders|Comments Off

Switching Antidepressants After the First Trimester

Q. I am currently talking Remeron for depression. I am about 16 weeks pregnant and doing well. I recently started working with a new psychiatrist, and my new doctor suggested that I switch to Prozac because he thought it would be safer for the baby. I am a little worried about making a change; I have never tried Prozac before and had a bad reaction (horrible anxiety and insomnia) when I tried Lexapro.

By MGH Center for Women's Mental Health|2015-08-11T11:50:58-04:00March 31st, 2008|Antidepressants, Pregnancy & Medications|Comments Off

PPHN and SSRIs: New Findings

Over the past few years, multiple reports have raised questions regarding the safety of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. Chambers and colleagues reported that exposure to SSRIs late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). In the general population, PPHN affects about 1 to 2 per 1000 live births. Infants with PPHN are typically full-term or near-term and present shortly after delivery with severe respiratory distress. In the worst cases, PPHN requires intubation and mechanical ventilation and may result in long-term morbidity. 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. 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).

By MGH Center for Women's Mental Health|2015-08-11T11:42:51-04:00March 31st, 2008|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off