pregnancy - MGH Center for Women's Mental Health

Atypical Antipsychotics during Pregnancy: What are the Risks?

Although primarily used to treat schizophrenia and other psychotic disorders, the newer “atypical” antipsychotic agents are now used widely to treat a spectrum of psychiatric disorders, including major depression, bipolar disorder, PTSD and other anxiety disorders. While the reproductive safety of the older typical antipsychotic drugs, such as haloperidol (Haldol) and perphenazine (Trilafon), is supported by data accumulated over the past 40 years, we have far less data on the newer atypical agents: olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), and clozapine (Clozaril).

By MGH Center for Women's Mental Health|2015-07-23T14:10:59-04:00December 30th, 2005|Antipsychotic Medications, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Neonatal Symptoms After In Utero Exposure to SSRIs

The increasing number of reproductive-age women taking antidepressants has raised concerns about the potential risks of using these medications during pregnancy. Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for "toxicity" in newborns exposed to antidepressants around the time of labor and delivery. These concerns are not new. Twenty years ago, case reports suggested that maternal use of tricyclic antidepressants near the time of delivery was associated with problems in the newborn such as difficulty feeding, restlessness, or jitteriness.

By MGH Center for Women's Mental Health|2015-07-22T15:28:43-04:00July 27th, 2005|Anxiety Disorders, Child Outcomes, Depressive Disorders, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Postpartum Depression: Who is at Risk?

Many women imagine new motherhood as a time of total fulfillment, days filled with mother-infant bonding and boundless joy. In reality, however, many women experience significant mood changes following childbirth. Between 50 and 85% of new mothers experience a brief postpartum period of tearfulness and anxiety, termed the "maternity blues." But some 10 to 15% of women experience postpartum depression, or PPD, a longer-lasting and more pervasive type of mood disorder.

By MGH Center for Women's Mental Health|2015-07-22T15:31:51-04:00June 20th, 2005|Postpartum Depression, Postpartum Psychiatric Disorders, Prevalence & Risk Factors|Comments Off

Can Women Taking Lithium Breastfeed Their Infants?

It is clear that women with bipolar disorder are at high risk for relapse during the immediate postpartum period (Viguera 2000). There is evidence that the resumption of lithium prior to or within 24-48 hours of delivery can significantly reduce the risk of postpartum illness (Cohen 1995). While this intervention is the current standard of care for this high risk population, women have historically been instructed to avoid breastfeeding while taking lithium based on early reports suggesting high levels of lithium in the breast milk and several cases of lithium toxicity in nursing infants (Schou 1973). While the American Academy of Pediatrics guidelines are less restrictive in their current recommendation, they do urge caution. However, systematic studies regarding the levels of exposure to lithium in nursing infants and the potential risks of this exposure have been lacking.

By MGH Center for Women's Mental Health|2018-07-11T14:35:47-04:00June 14th, 2005|Breastfeeding & Medications, Child Outcomes, Mood Stabilizers|Comments Off

Should SSRIs Be Discontinued Prior to Delivery?

About 10-15% of women suffer from depression during pregnancy. The rates are probably even higher among those women who have histories of depression prior to pregnancy. Thus, many women with recurrent illness make the decision to remain on antidepressant during pregnancy. While there have been many studies supporting the reproductive safety of certain antidepressants, including Prozac and the tricyclic antidepressants, during pregnancy, concerns have emerged as to whether antidepressants, including the selective serotonin reuptake inhibitors (SSRIs), may increase the risk of adverse events in the newborn.

By MGH Center for Women's Mental Health|2015-07-22T14:41:25-04:00June 13th, 2005|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Is Wellbutrin Safe During Pregnancy?

Q. I have a long history of depression and have been taking Wellbutrin (bupropion SR) for several years now. Every time I try to come off the medication, the depression comes back. I am planning to get pregnant within the next year and was wondering if it is safe to use Wellbutrin.

By MGH Center for Women's Mental Health|2015-07-21T13:56:08-04:00April 15th, 2005|Pregnancy & Medications|Comments Off

Recent Antidepressant Label Changes

In October, the Food and Drug Administration (FDA) ordered drug manufacturers to include warnings in the packaging inserts regarding the use of certain antidepressants, including the selective serotonin reuptake inhibitors (SSRIs) and venlafaxine (Effexor), during pregnancy. The labels now describe a spectrum of adverse events in newborns exposed to these drugs late in the third trimester, including jitteriness, irritability, hypoglycemia (low blood sugar), feeding difficulties, respiratory distress, abnormal muscle tone, and constant crying. Complications requiring “prolonged hospitalization, respiratory support and tube feeding” are also mentioned.

By MGH Center for Women's Mental Health|2015-07-21T12:51:48-04:00April 15th, 2005|Antidepressants, Pregnancy & Medications|Comments Off

Acupuncture for Depression During Pregnancy

Depression during pregnancy is relatively common, affecting about 10 to 15% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, our understanding of how these psychotropic medications affect the developing fetus remains incomplete. For this reason, many women and their physicians would prefer to avoid the use of antidepressants during pregnancy; thus, there is a clear need for effective non-pharmacologic treatments for women who suffer from depression during pregnancy. In a recent study from Dr. Rachel Manber and her colleagues at Stanford University, the use of acupuncture is assessed in a group of pregnant depressed women.

By MGH Center for Women's Mental Health|2015-07-21T11:46:39-04:00February 14th, 2005|Alternative & Complementary, Depressive Disorders, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Pregnancy and SSRIs: Is There a Risk to the Newborn?

The increasing number of reproductive-age women taking antidepressants has raised concerns about the potential risks of using these medications during pregnancy. Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for “toxicity” in newborns exposed to antidepressants around the time of labor and delivery. These concerns are not new. Twenty years ago, case reports suggested that maternal use of tricyclic antidepressants near the time of delivery was associated with problems in the newborn such as difficulty feeding, restlessness, or jitteriness.

By MGH Center for Women's Mental Health|2015-07-21T11:39:06-04:00October 15th, 2004|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

Long-term Effects of Fetal Exposure to Antidepressants

Although data accumulated over the last 30 years suggest that some medications may be used safely during pregnancy, our knowledge regarding the risks of prenatal exposure to psychotropic medications is incomplete. Because neuronal migration and differentiation occur throughout pregnancy and into the early years of life, the central nervous system (CNS) remains particularly vulnerable to toxic agents throughout pregnancy. While insults that occur early in pregnancy may result in gross abnormalities, exposures that occur after neural tube closure (at 32 days of gestation) may produce more subtle changes in behavior and functioning.

By MGH Center for Women's Mental Health|2015-07-21T11:25:18-04:00March 31st, 2003|Antidepressants, Child Outcomes, Long-Term Outcomes, Pregnancy & Medications|Comments Off