• medication during pregnancy

    Anticonvulsant Use in Pregnancy and Nursing: Differences in Recommendations from Psychiatrists vs. Neurologists

    There are strong parallels between the clinical management of bipolar disorder and epilepsy, and women with these disorders face significant challenges while pregnant or planning to conceive.  In this setting, treatment decisions must balance the risks of recurrence of severe illness with the risks of potential harm to the fetus when certain medicines are taken during pregnancy.

    What Would You Do? A Pregnant Women on Duloxetine (Cymbalta)

    Ms. A is a 27-year-old woman who is seven weeks pregnant and is currently taking duloxetine (Cymbalta).  She has a history of recurrent major depressive disorder (MDD) and has had a good response to duloxetine at 60 mg per day.  She has had four previous episodes of major depressive disorder (most untreated) and has been in remission for one year.  Past episodes have lasted up to six months and caused difficulty with functioning at work and in relationships, although she was not diagnosed and treated until one year ago. 

    Melatonin in Pregnancy: Is it Safe?

    Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. In a previous post, we discussed the use of different types of medications to treat insomnia during pregnancy. While these drugs are highly effective, many women with sleep problems inquire about the use of "natural" agents, such as melatonin, during pregnancy.

    Long-term Effects of Fetal Exposure to Antidepressants

    Although data accumulated over the last 30 years suggest that some medications may be used safely during pregnancy, our knowledge regarding the risks of prenatal exposure to psychotropic medications is incomplete. Because neuronal migration and differentiation occur throughout pregnancy and into the early years of life, the central nervous system (CNS) remains particularly vulnerable to toxic agents throughout pregnancy. While insults that occur early in pregnancy may result in gross abnormalities, exposures that occur after neural tube closure (at 32 days of gestation) may produce more subtle changes in behavior and functioning.

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