• medication safety

    Sleep Medications: What Information Do We Have on Reproductive Safety?

    It is estimated that up to 95% of women experience some type of sleep disturbance during pregnancy.  While for many women the insomnia is relatively benign and may respond to simple interventions, other women experience more severe insomnia which has a significant impact on their quality of life and ability to function.  Various non-benzodiazepine hypnotic agents, specifically zalepion (Sonata), eszopiclone (Lunesta), and zolpidem (Ambien), are commonly used for the short-term treatment of insomnia; however, information regarding the reproductive safety of these sleep aids has been sparse.

    Valproic Acid and the Risk of Major Malformations

    Previous studies have indicated that infants exposed to valproic acid in pregnancy are at increased risk for a range of malformations, including neural tube defects.  While these studies have shown an association between valproic acid and various malformations, they have been limited in their ability to quantify the risk of certain, less common malformations.  To do this, large population-based case–control studies are more appropriate.

    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.

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