• mood disorders

    You Asked: Should Lamotrigine (Lamictal) Dose Be Adjusted During Pregnancy?

    For many women with bipolar disorder, lamotrigine (Lamictal) is an effective mood stabilizer.  Given its relatively favorable reproductive safety profile, lamotrigine is a reasonable option for women who require treatment with a mood stabilizer during pregnancy.

    Hormonal Treatments for Breast Cancer: Do They Cause Depression?

    Aromatase inhibitors (AIs) are the preferred hormonal therapy for postmenopausal women with estrogen sensitive breast cancer.  While the selective estrogen receptor modulators (SERMs), such as tamoxifen and raloxifene, are used in premenopausal women with estrogen sensitive breast cancer, the aromatase inhibitors (e.g., anastrozole, letrozole, and exemestane) have been shown to be more effective and safer than the SERMs in postmenopausal women. 

    L-Methylfolate for the Treatment of Depression: Can We Use it During Pregnancy?

    Last summer, we posted a blog about using folate to treat (and perhaps prevent) depression in women of childbearing age.  Supporting that recommendation are the several reports indicating that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms.  Other studies have indicated that in folate-deficient patients, antidepressants may be less effective or may take longer to take effect.

    Hyperemesis Gravidarum and Depression: Which Comes First?

    Most women have some nausea or vomiting, or "morning sickness", during the first trimester of pregnancy.  Some women, however, have a more severe and persistent pattern of nausea and vomiting called hyperemesis gravidarum (HG).  A new study demonstrates, not so surprisingly, that depression is more common in women suffering from HG.   

    Brief Scales for Identifying Postpartum Depression and Anxiety

    While most agree that there is a need for improved detection of anxiety and mood disorders in pregnant and postpartum women, there remain questions regarding the best instruments to use for screening.  The Edinburgh Postnatal Depression Scale (a questionnaire consisting of 10 items) has long been used to screen women for postpartum depression (PPD); however, it is unclear how well these questions could be incorporated into larger surveillance programs, such as the CDC-sponsored Pregnancy Risk Assessment Monitoring System (PRAMS) which was designed to assess health behaviors and to screen for health problems, including depression and anxiety, in pregnant and postpartum women.

    Duloxetine and Pregnancy: Preliminary Data

    Duloxetine (sold in the United Sates under the brand name of Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) effective for major depressive disorder and generalized anxiety disorder (GAD).  Although used fairly commonly in women of child-bearing age, information regarding its reproductive safety has been lacking.

    New Research from the CWMH: Surgically Induced Menopause No Worse than Natural in Terms of Risk for Depression, Anxiety

    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. 

    Infertility Increases Risk of Serious Psychiatric Illness

    Multiple small studies have demonstrated a link between infertility and psychological distress, reporting high rates of anxiety and depressive symptoms among women with infertility.  These studies have evaluated psychiatric symptoms or psychological distress; however, less is known about the prevalence of more significant psychiatric disorders in this population.  

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