women's mental health - MGH Center for Women's Mental Health

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

Venlafaxine (Effexor) for Postmenopausal Hot Flushes

During the menopausal transition, up to 85% of women experience vasomotor symptoms of hot flushes and night sweats. For many women, hot flushes may be severe; they can interfere with work and other daily activities and affect sleep quality. Hot flushes may be associated with fatigue, poor concentration, and depression. Given the recent data from the Women's Health Initiative regarding the risks associated with long-term use of estrogen, many peri- and post-menopausal women are understandably reluctant to take menopausal hormone therapy for the treatment of hot flushes, despite its proven efficacy. Given these concerns, there is a clear need for alternative non-hormonal therapies for the treatment of hot flushes and other menopause-related symptoms.

By MGH Center for Women's Mental Health|2015-07-21T11:41:35-04:00January 18th, 2005|Medication, Menopausal Symptoms, 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

Paroxetine and Cognitive-Behavioral Therapy (CBT) for the Treatment of Postpartum Depression (PPD)

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Non-pharmacologic interventions, including interpersonal psychotherapy, have been shown to be effective for the treatment of PPD. In addition, several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) and the serotonin norepinephrine reuptake inhibitor venlafaxine (Effexor). In a recent report, Misri and colleagues have evaluated whether the addition of Cognitive-Behavioral Therapy (CBT) to standard antidepressant treatment improves outcomes in women with postpartum depression and co-morbid anxiety.

By MGH Center for Women's Mental Health|2015-07-21T11:37:31-04:00September 20th, 2004|Medication, Postpartum Depression, Postpartum Psychiatric Disorders, Psychotherapy, Treatment|Comments Off

Infertility Treatment: A Trigger for Depression and Anxiety

While several studies have demonstrated high levels of psychological distress among women pursuing infertility treatment, few studies have assessed the prevalence of psychiatric illness in populations undergoing infertility treatment using standardized diagnostic instruments. In a recent study from Taipei Veterans General Hospital, a university-affiliated medical center in Taiwan, women attending an assisted reproduction clinic were assessed using the Mini-International Neuropsychiatric Interview (MINI) (Chen 2004) Of the 112 participants, 40.2% met criteria for a psychiatric disorder. The most common diagnosis was generalized anxiety disorder (23.2%), followed by major depressive disorder (17.0%) and dysthymic disorder (9.8%). Participants with a psychiatric disorder did not differ from those without illness in terms of age, education level, income, or years of infertility.

By MGH Center for Women's Mental Health|2015-07-21T11:30:27-04:00August 18th, 2004|Anxiety Disorders, Depressive Disorders, Infertility and Mental Health, Prevalence & Risk Factors|Comments Off

Prevention of Postpartum Depression

Postpartum depression (PPD) is a relatively common problem, affecting between 10% and 15% of women after delivery. Although it is difficult to reliably predict which women in the general population will experience postpartum mood disturbance, it is possible to identify certain subgroups of women who are more vulnerable to postpartum affective illness. Women who have had one episode of postpartum depression have about a 50% chance of experiencing another episode of PPD after a subsequent pregnancy. The extent to which a history of depression (prior to pregnancy) influences risk is less clear, but some studies indicate that between 30% and 50% will suffer from recurrent depression during the postpartum period. Several investigators have recently explored the potential efficacy of prophylactic interventions in these populations of women at risk.

By MGH Center for Women's Mental Health|2015-08-07T22:57:38-04:00July 20th, 2004|Postpartum Depression, Postpartum Psychiatric Disorders, Prevention|Comments Off

Is St. John’s Wort Safe in Breastfeeding Women?

Postpartum depression is a relatively common event, affecting 10 to 15% of women after the birth of a child. Many women, however, do not receive treatment, and one of the most common reasons for avoiding or deferring treatment is concern regarding the use of medications while breastfeeding. A preliminary study from Lee and colleagues at the Motherisk Program in Toronto, Canada has investigated the use of St. John’s wort in breastfeeding women.

By MGH Center for Women's Mental Health|2015-07-21T11:28:28-04:00January 18th, 2004|Antidepressants, Breastfeeding & Medications|Comments Off

women’s mental health