This is a relatively small study but I think it underscores the importance of screening for and treating depression during pregnancy. Previous studies have indicated that about 10% to 15% of women experience clinically significant depressive symptoms during pregnancy; however, depression that emerges during pregnancy often goes untreated. A recent naturalistic study from Turkey followed […]
Tag Archives | medication
The following post was first published in OB/GYN News.
Autism spectrum disorders (ASDs), which include childhood autism, autistic disorder, Asperger syndrome, atypical autism, and other pervasive developmental disorders, are characterized by social and communication difficulties and by stereotyped or repetitive behaviors and interests. It is estimated that autism spectrum disorders affect about 1% of children. While genes play a significant role in the risk […]
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.
Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data regarding the reproductive safety of these medications.
Ever since 2002 when several large-scale studies called into question the safety of long-term hormone replacement therapy (HRT), there has been confusion and conflicting opinions regarding the management of menopausal symptoms. Initially there was a movement to avoid HRT altogether; now it is becoming clearer that certain women may safely use and benefit from hormonal interventions.
In this essay published in the Journal of the American Medical Association, Dr. Helen Kim (an alumna of the CWMH) discusses the challenges of treating women with severe psychiatric illness during pregnancy:
With increasing frequency, postpartum women who have taken antidepressants during pregnancy have shared – usually in tears – that while in the hospital for their labor and delivery hospitalization, a health care provider at the hospital said something judgmental about their being on an antidepressant. For example, one woman said that a nurse told her, “I can’t believe you took that during pregnancy.” Or, “Don’t you know how risky that is?!” Or “How could you do that to your baby?” This is often in the context of women using other medications in parallel for non-psychiatric indications, of which less may be known about the reproductive safety profile, but not addressed by the health care provider.
A clinician asks: “I am a psychiatrist treating a patient with Bipolar Disorder on Seroquel and Topamax. I would like to know what information is available regarding the safety of these medications to the infant if used during breastfeeding.”