While there are concerns regarding the risks associated with prolonged use of hormone replacement, an increasing number of studies suggest that the risk may be relatively low in certain settings. A study presented this week at the Endocrine Society’s annual meeting which analyzed data from 43 randomized clinical trials suggests that menopausal hormone-replacement therapy does not appear to affect mortality either positively or negatively.
Tag Archives | Center for Women’s Mental Health
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.
The following post was first published in OB/GYN News.
This is the second part of a two part series on the use of antipsychotic medications during pregnancy. Read Part 1 here, which reviews data from the Australian antipsychotic registry.
We would like to thank you for your continuing support of the National Pregnancy Registry for Atypical Antipsychotics (NPRAA) at the Center for Women’s Mental Health at Massachusetts General Hospital. We are grateful for all the referrals made to the Registry as our numbers continue to grow every day. Given the Registry’s successful enrollment, we are pleased to announce our plan to release preliminary data at an upcoming conference in June, the American Society of Clinical Psychopharmacology (ASCP) Annual Meeting.
Over the last decade, attention in the medical literature has gathered logarithmically to focus on potentially efficacious treatments for perinatal depression. Studies of relevant databases, editorials, and various reviews have addressed the reproductive safety concerns of antidepressant treatments, particularly selective serotonin reuptake inhibitors (SSRIs) on one hand, and the impact of untreated maternal psychiatric illness on fetal and maternal well-being on the other.
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.
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.
Each year about 600,000 women in the United States undergo a hysterectomy. Somewhere between 55% and 80% of these women who also have their ovaries removed along with the uterus—a procedure known as oophorectomy. After the removal of the ovaries, menopause follows immediately and is associated with a constellation of symptoms including hot flashes and insomnia, as well as depression and anxiety.
The National Comorbidity Survey estimates that by the time women reach midlife, approximately 23% have experienced at least one episode of major depression and 30% have been diagnosed with an anxiety disorder. Depression and anxiety disorders are each associated with impaired functioning and lower quality of life (QOL). There is also some data to suggest that, even after a depressive episode resolves, those with a history of a affective illness have a lower quality of life than those without histories of depression, with impairment in social and interpersonal functioning.