SSRI - MGH Center for Women's Mental Health

Measuring the Effects of Antidepressants versus Untreated Depression on Pregnancy Outcomes

Multiple studies have demonstrated an increased risk of poor neonatal adaptation associated with exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy. Results in the literature consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaption, including jitteriness, restlessness, increased muscle tone, rapid breathing. These symptoms are transient, resolving spontaneously with no specific medical intervention.

By MGH Center for Women's Mental Health|2015-08-12T13:56:55-04:00July 10th, 2012|Psychiatric Disorders During Pregnancy|0 Comments

CBT for the Prevention of Postpartum OCD

Given the prevalence of postpartum OCD and obsessive symptoms in women with postpartum depression, we should devote more time to this topic. This is an informative and well-written article by Alice Wolton on postpartum OCD in Forbes. In this piece, she mentions a recent study from Timpano and colleagues at the University of Miami where cognitive behavioral therapy (CBT) was used to prevent postpartum OCD.

By MGH Center for Women's Mental Health|2015-08-12T14:52:07-04:00June 5th, 2012|Postpartum Psychiatric Disorders|2 Comments

Escitalopram (Lexapro) for Hot Flashes: No Significant Sexual Side Effects

Escitalopram, when used in the treatment of menopausal vasomotor symptoms, did not worsen overall sexual function among non-depressed midlife women.

By MGH Center for Women's Mental Health|2015-08-12T16:15:15-04:00May 21st, 2012|Menopausal Symptoms|0 Comments

Choice of Antidepressant May Affect Survival in Women on Tamoxifen for Breast Cancer

Tamoxifen is a SERM (selective estrogen receptor modulator) used in women with breast cancer; it reduces the risk of relapse and improves overall survival. Tamoxifen may also be used to reduce the risk of breast cancer in women at high risk for the disease. In order to be fully effective, tamoxifen must be metabolized to an active metabolite, endoxifen, by the liver enzyme CYP2D6. Consequently, any co-administered agent that inhibits this enzyme will reduce the conversion of tamoxifen to endoxifen, thereby potentially reducing the efficacy of tamoxifen as a breast cancer therapy.

By MGH Center for Women's Mental Health|2019-11-03T22:28:44-04:00May 2nd, 2011|Antidepressants, Menopausal Symptoms|2 Comments

New Research from the CWMH: Escitalopram (Lexapro) for Hot Flashes

For decades, estrogen has been used to treat menopausal symptoms, including night sweats and hot flashes. However, after studies reported that estrogen increases the risk of cardiovascular disease and breast cancer, many patients and clinicians have looked into alternative treatments for hot flashes, including selective serotonin reuptake inhibitors (SSRIs). According to a new study published in the Journal of the American Medical Association, treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro) significantly reduces the frequency and severity of menopausal hot flashes compared with placebo.

By MGH Center for Women's Mental Health|2016-03-28T13:02:56-04:00February 3rd, 2011|Menopausal Symptoms, New Research|10 Comments

Should SSRIs Be Tapered Prior To Delivery?

Increased muscle tone, jitteriness, sleep disturbance, irritability, feeding problems, mild respiratory distress and myoclonus have been reported as symptoms of a potential neonatal distress syndrome related to exposure to SSRIs in late pregnancy. The average duration of symptoms reported is 48 hours. It is estimated that between 25-30% of SSRI-exposed infants are at risk for this syndrome. No treatment intervention is required. Reassuringly, follow-up studies have shown that at 2, 4, 6, and 8 months SSRI-exposed infants are indistinguishable from control infants without known exposure.

By MGH Center for Women's Mental Health|2015-08-12T17:01:53-04:00September 8th, 2010|Psychiatric Disorders During Pregnancy|2 Comments

Premenstrual Syndromes: What is the Optimal Duration of Treatment?

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) affect a large number of women of childbearing age. 30-80% of reproductive age women experience premenstrual symptoms. PMS refers to a pattern of physical, emotional, and behavioral symptoms occurring 1-2 weeks before menses and remitting with the onset of menses. Common symptoms include fatigue, poor concentration, mild mood changes, headaches, abdominal bloating, and breast tenderness.

By MGH Center for Women's Mental Health|2015-08-12T15:32:28-04:00December 21st, 2009|PMS and PMDD|2 Comments

Paroxetine (Paxil) May Affect Sperm Quality

Within the field of psychiatry, there is a growing body of literature studying the use of antidepressants in women in the context of pregnancy and the postpartum period. However, much less attention has focused on the impact of these drugs on fertility, particularly in men. Because major depressive disorders affect about one in 10 American men over their lifetimes, it is essential to study the effects of antidepressants on male fertility.

By MGH Center for Women's Mental Health|2015-07-28T13:31:57-04:00October 1st, 2009|Infertility and Mental Health|4 Comments

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

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