• selective serotonin reuptake inhibitor

    Stellate Ganglion Blockade for Vasomotor Symptoms

    A study to be published in an upcoming issue of Menopause suggests that stellate ganglion blockade (SGB) may be an effective option for women with vasomotor symptoms (VMS), including hot flashes and night sweats.  SGB is used primarily for pain management and involves the injection of local anesthetic into the stellate ganglion, part of the sympathetic nerve system located in the neck.

    Good News: New Studies Show No Association Between Antidepressants and Risk of Autism

    Two recent epidemiologic studies have demonstrated an association between prenatal exposure to selective serotonin reuptake inhibitor antidepressants (SSRIs) with autism spectrum disorders (ASD; Croen et al 2011, Rai et al, 2013).  One important imitation of these two studies is that parental psychiatric disorder in itself is associated with an increased risk of ASD in the offspring, and these studies could not distinguish between the effects of drug exposure and the consequences of the underlying maternal psychiatric illness.  Two new studies shed light on the association between prenatal antidepressant exposure and risk of autism spectrum disorder in the offspring.

    Prenatal Exposure to Antidepressants and Risk of Autism

    It is estimated that autism spectrum disorders (ASD) affect about 1% to 2% of children.  Research carried out in twins and families indicate that ASD is highly heritable; however, it is generally believed that while  genetic factors play an important role, there is an interplay between genetic and environmental factors in the etiology of this disorder.  Various environmental exposures have been implicated, including vaccinations, mercury, air pollution, insecticides, and infection.

    New Research from the CWMH: Vasomotor Symptoms Frequently Recur After Discontinuation of SSRI

    For the treatment of menopausal vasomotor symptoms (VMS), such as hot flashes and night sweats, selective serotonin reuptake inhibitors (SSRIs) are effective and well-tolerated.  Positive effects are observed within 4 weeks of the initiation of treatment.  However, we do not know how long treatment with an SSRI must be continued in order to maintain control of VMS. Nor do we know if VMS will recur after discontinuation of SSRI or if recurrent VMS may be less frequent or less bothersome after receiving SSRI treatment. A recent report from Dr. Hadine Joffe and colleagues at the Center for Women’s Mental Health assessed the recurrence of vasomotor symptoms in women treated with SSRIs.

    Dr. Lee Cohen in Ob-Gyn News: Using SSRIs in Pregnancy

    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.

    SSRIs and Pregnancy: Putting the Risks and Benefits into Perspective

    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.

    Exposure to Maternal Depression – Not Antidepressants – Predicts Worse Outcomes in Children

    While data accumulated over the last 30 years suggest that certain antidepressants may be used with relative safety 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, development of the central nervous system (CNS) remains particularly vulnerable throughout pregnancy.

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