pregnancy

What is the Impact of Depression During Pregnancy?

In a recent study by Gerardin and colleagues, the authors note that more research has been done to demonstrate the consequences of postpartum depression than depression during pregnancy (also called antenatal or prenatal depression).  Infants born to mothers with depression during pregnancy have been demonstrated to have lower scores on motor behavior and more crying and irritability.  Few studies, however, have assessed the longer-term effects of antenatal depression.

By |2015-07-28T14:40:30-04:00July 12th, 2011|Depressive Disorders, Outcomes, Psychiatric Disorders During Pregnancy|Comments Off on What is the Impact of Depression During Pregnancy?

Serotonin Reuptake Inhibitors and Fertility (Part 2): What Can Basic Science Tell Us?

Serotonin (5-HT) is one of the neurotransmitters involved in mood regulation and has been implicated in the development of mood and anxiety disorders.  Serotonin transporters (SERT) facilitate the transfer of serotonin into neurons; serotonin reuptake inhibitor (SSRI) antidepressants bind to these transporters and appear to exert their effect on mood by inhibiting the reuptake of serotonin and thus increasing the levels of this neurotransmitter at the synapse.

By |2015-07-28T14:39:53-04:00July 5th, 2011|Antidepressants, Pregnancy & Medications|Comments Off on Serotonin Reuptake Inhibitors and Fertility (Part 2): What Can Basic Science Tell Us?

Serotonin Reuptake Inhibitors and Fertility (Part 1): A Clinical Perspective

We previously reported that paroxetine, a selective serotonin reuptake inhibitor (SSRI), may affect sperm motility and may thus have a negative impact on male fertility.  Many women who are planning a pregnancy question whether SSRIs and other antidepressants may affect fertility; this is obviously a particularly important issue for those who are having difficulty conceiving.

By |2015-07-28T14:39:33-04:00July 1st, 2011|Antidepressants, Pregnancy & Medications|Comments Off on Serotonin Reuptake Inhibitors and Fertility (Part 1): A Clinical Perspective

Generalized Anxiety in Pregnancy

Few studies have focused on anxiety disorders in the perinatal period. While various studies have measured levels of anxiety or distress during pregnancy, most studies have relied upon self-report questionnaires to assess for anxiety.  In contrast, few studies have used standardized diagnostic criteria to determine the prevalence of anxiety disorders in pregnant populations.   In a recent study, Buist and colleagues studied the prevalence and course of generalized anxiety disorder (GAD) in a prospectively ascertained population of pregnant women.

By |2015-04-10T13:27:22-04:00June 21st, 2011|Anxiety Disorders, Diagnosis & Screening, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy|Comments Off on Generalized Anxiety in Pregnancy

Clinical Case: Should SSRIs Be Tapered Prior To Delivery?

Ms. T is a 33 year old woman with a history of recurrent depression who is 32 weeks    pregnant with her first pregnancy.  She has remained on her citalopram (Celexa) throughout pregnancy and has been well.  Her gynecologist has encouraged her to enquire about coming off the Celexa prior to delivery in order to avoid symptoms of neonatal distress.  What should she do?

By |2015-07-28T14:36:21-04:00June 13th, 2011|Antidepressants, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off on Clinical Case: Should SSRIs Be Tapered Prior To Delivery?

Anxiety During Pregnancy: How Does it Affect the Developing Fetal Brain?

During fetal life, neurons proliferate, migrate and form connections, providing the structure of the developing brain. Neurons reach their final destinations by the 16th week of gestation, while branching and making appropriate connections occur even before that time (1). The brain continues to develop during the entire pregnancy, with most of the synapse formation in the developing brain happens during the third trimester (2).

By |2016-09-01T11:40:38-04:00April 11th, 2011|Anxiety Disorders, Child Outcomes, Neurodevelopmental Disorders, Psychiatric Disorders During Pregnancy|Comments Off on Anxiety During Pregnancy: How Does it Affect the Developing Fetal Brain?

Making Individual Decisions Regarding the Use of Antidepressants During Pregnancy

Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy.  This choice can be especially difficult for women taking newer medications which lack adequate reproductive safety data.

By |2015-07-28T14:27:36-04:00March 14th, 2011|Antipsychotic Medications, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off on Making Individual Decisions Regarding the Use of Antidepressants During Pregnancy

New FDA Warning on the Use of Antipsychotic Medications in Pregnancy

On February 22, 2011, the U.S. Food and Drug Administration (FDA) informed healthcare professionals that drug labels for the entire class of antipsychotic drugs have been updated to include warnings regarding the use of antipsychotic drugs during pregnancy. The new drug labels now contain more details on the potential risk for abnormal muscle movements (extrapyramidal signs or EPS) and withdrawal symptoms in newborns exposed to these drugs during the third trimester of pregnancy.

By |2015-07-28T14:26:32-04:00March 9th, 2011|Antipsychotic Medications, Child Outcomes, Pregnancy & Medications|Comments Off on New FDA Warning on the Use of Antipsychotic Medications in Pregnancy

Zolpidem (Ambien) in Pregnancy: Is it Safe?

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.  While zolpidem (Ambien), a sedative-hypnotic agent used for the short-term treatment of insomnia, is commonly prescribed in pregnant women, the information regarding its reproductive safety has been sparse.

By |2015-08-13T11:45:40-04:00November 22nd, 2010|Pregnancy & Medications, Sleep Disorders|Comments Off on Zolpidem (Ambien) in Pregnancy: Is it Safe?
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