pregnancy - MGH Center for Women's Mental Health

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.

By MGH Center for Women's Mental Health|2015-08-12T14:50:32-04:00June 29th, 2009|Psychiatric Disorders During Pregnancy|4 Comments

Do SSRIs Increase the Risk of Preeclampsia?

Hypertension in pregnancy is generally defined as a diastolic blood pressure of 90 mm Hg or greater or a systolic pressure at or above 140 mm Hg. Preeclampsia is defined as the development of hypertension with proteinuria or edema induced by pregnancy, generally in the second half of gestation. It is more common in women who have not carried a previous pregnancy beyond 20 weeks and in women at the extremes of the reproductive years.

By MGH Center for Women's Mental Health|2015-07-28T11:31:33-04:00June 22nd, 2009|Psychiatric Disorders During Pregnancy|0 Comments

OCD in Pregnant and Postpartum Women

The lifetime prevalence rate of obsessive-compulsive disorder (OCD) has been consistently estimated to be 2%-3% in the general adult population throughout the world, making OCD one of more common psychiatric diagnoses; however research on OCD in pregnancy and peurperium has been limited.

By MGH Center for Women's Mental Health|2015-08-12T14:45:14-04:00June 18th, 2009|Psychiatric Disorders During Pregnancy|0 Comments

Maternal Depression During Pregnancy May Lead to Infant Sleep Problems

About 15% of women suffer from depression during pregnancy, and many reports have suggested that depression during pregnancy may have negative effects on the fetus. A new study from researchers at the University of Michigan indicates a link between depression during pregnancy and infant sleep problems.

By MGH Center for Women's Mental Health|2015-08-12T14:34:16-04:00May 12th, 2009|Psychiatric Disorders During Pregnancy|1 Comment

Pregnancy May Lower Lamotrigine (Lamictal) Blood Levels

Women with bipolar disorder are at increased risk for recurrence of illness during pregnancy. Therefore, many women with bipolar disorder elect to continue treatment with medications during pregnancy after weighing the risks and benefits of various treatment options with their physicians. Lamotrigine (Lamictal) is an anticonvulsant used to treat bipolar disorder. While the safety data on this relatively new anticonvulsant in pregnancy is limited, pregnancy registry data suggests that lamotrigine may pose less of a risk to the developing fetus than with older anticonvulsants, such as valproate (Depakote). With lamotrigine emerging as an effective and relatively safe treatment for pregnant women with bipolar disorder, more attention is now being paid to the effects of pregnancy on lamotrigine levels.

By MGH Center for Women's Mental Health|2018-07-11T13:30:12-04:00May 5th, 2009|Psychiatric Disorders During Pregnancy|1 Comment

Fetal Exposure to Valproate Associated with Lower IQ

There have long been concerns regarding the use of the anticonvulsant valproate (Depakote) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart, limbs, and genitals. A recent report published in the New England Journal of Medicine indicates that in utero exposure to valproate may also result in lower IQ.

By MGH Center for Women's Mental Health|2015-08-12T14:22:13-04:00April 24th, 2009|Psychiatric Disorders During Pregnancy|0 Comments

Antenatal Use of SSRIs and QT Interval Prolongation in Newborns

Over the last several years, a number of studies have indicated that exposure to antidepressants near the time of delivery may be associated with poor neonatal outcomes. A recent prospective study from Dubnov-Raz and colleagues published in the journal Pediatrics found an association between QTc interval prolongation in neonates and antenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants. The QT interval is a measurement of the heart's electrical cycle from ventricular depolarization to the end of ventricular polarization. It is determined from an electrocardiogram (ECG) and is corrected for heart rate.

By MGH Center for Women's Mental Health|2015-08-12T14:14:31-04:00March 24th, 2009|Psychiatric Disorders During Pregnancy|0 Comments

Using New Research to Inform Treatment Decisions during Pregnancy: A Case Report

As more research is conducted within the field of women's mental health, there are times when recommendations may change depending on the available data. We will discuss a case here to illustrate this point.

By MGH Center for Women's Mental Health|2015-08-12T14:09:25-04:00March 17th, 2009|Psychiatric Disorders During Pregnancy|2 Comments

A Mouse Model of Postpartum Depression

Maguire and Mody's report, GABAA R Plasticity during Pregnancy: Relevance to Postpartum Depression, in the July 2008, Neuron, provides evidence that an abnormal Gamma-aminobutyric acid (GABAA) receptor subunit in pregnant mice may be a useful model for postpartum depression. The report describes how GABAA receptors, specifically, the delta-subunit-containing GABA receptor, are a preferred target for neurosteroids. They designed a study to identify functional changes in these receptors during pregnancy and postpartum and then looked at possible behavioral correlates in the mice.

By MGH Center for Women's Mental Health|2015-08-12T14:07:14-04:00March 10th, 2009|Postpartum Psychiatric Disorders|0 Comments

Case: Prevention of Mood Episodes When Planning for Pregnancy

Our Perinatal and Reproductive Psychiatry team often discusses clinical cases in Rounds, a confidential forum in which we can get advice and consultation from peers who also work in the area of Women's Mental Health. We discussed a patient's situation recently that highlighted the controversial area about how to prevent mood episodes in a woman planning for pregnancy.

By MGH Center for Women's Mental Health|2015-08-12T14:05:35-04:00March 2nd, 2009|Postpartum Psychiatric Disorders, Psychiatric Disorders During Pregnancy|1 Comment