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CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ECT FOR THE TREATMENT OF SEVERE POSTPARTUM DEPRESSION Ultra-Brief ECT for the Treatment of Severe Postpartum Depression. This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ECT FOR THE TREATMENT OF SEVERE POSTPARTUM DEPRESSION Ultra-Brief ECT for the Treatment of Severe Postpartum Depression. This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. BIPOLAR DISORDER AND THE MENOPAUSAL TRANSITION Bipolar Disorder and the Menopausal Transition. Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder. At the American Psychiatric Association’s 2014 AnnualMeeting
ESSENTIAL READS: SCREENING FOR PERINATAL ANXIETY DISORDERS This 31-item questionnaire is easy to complete and score, is sensitive to how anxiety presents in perinatal women and may be used in a variety of settings. This scale assesses four categories of anxiety: (1) acute anxiety and adjustment, (2) general worry and specific fears, (3) perfectionism, control and trauma and (4) social anxiety. THE EFFECTS OF MARIJUANA ON EMBRYO DEVELOPMENT Disruption of these tightly regulated signaling pathways by exogenous cannabinoids may have a number of downstream adverse effects on: (1) Obstetrical Outcomes (ie., preimplantation and implantation), and (2) Embryo Development (ie., direct effects on the fetus). SLEEP PROBLEMS IN MENOPAUSAL WOMEN Sleep Problems in Menopausal Women. Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primarysleep disorder.
MORE MIDLIFE WOMEN USING CANNABIS TO MANAGE PERIMENOPAUSAL According to a study results presented during the 2020 Virtual Annual Meeting of The North American Menopause Society (NAMS), more perimenopausal women may be considering the use of cannabis for the management of their menopausal symptoms. In a survey of 232 women (average age 56 years) participating in the Midlife Women VeteransHealth Survey
POST TRAUMATIC STRESS DISORDER AND PREGNANCY Understanding post traumatic stress disorder (PTSD) during pregnancy is important given that PTSD is relatively common and persistent in nature. PTSD will occur in approximately 10% of women in their lifetime, with one-third of episodes lasting more than five years. Given the relatively high prevalence of PTSD in young women and thechronic
TIMING OF POSTPARTUM DEPRESSION ONSET MAY PREDICT SYMPTOM Postpartum depression (PPD) is a common and complicated illness, affecting about 15% of women in the perinatal period. Recent research from the PACT consortium (Postpartum Depression: Action Toward Causes and Treatment) has sought to classify the many potential subtypes of this heterogenous illness and has found emerging differences in time of onset, severity, comorbid anxiety, INTERMITTENT DOSING OF SSRIS FOR PMS Intermittent Dosing of SSRIs for PMS. Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression and anxiety that occur during the 1-2 weeks before the menstrual period but may also help alleviate FLUVOXAMINE AND PREGNANCY: IS THERE A RIGHT CHOICE? A summary of the data from these studies is above. While these studies are indeed reassuring in regards to the risk of congenital malformations with exposure to fluvoxamine during pregnancy, they highlight how infrequently fluvoxamine is used in pregnancy compared to the other SSRIs and, subsequently, how relatively few exposures we have for fluvoxamine in pregnancy compared to IS IT SAFE TO TAKE ADHD MEDICATIONS WHILE BREASTFEEDING In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ECT FOR THE TREATMENT OF SEVERE POSTPARTUM DEPRESSION Ultra-Brief ECT for the Treatment of Severe Postpartum Depression. This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ECT FOR THE TREATMENT OF SEVERE POSTPARTUM DEPRESSION Ultra-Brief ECT for the Treatment of Severe Postpartum Depression. This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. BIPOLAR DISORDER AND THE MENOPAUSAL TRANSITION Bipolar Disorder and the Menopausal Transition. Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder. At the American Psychiatric Association’s 2014 AnnualMeeting
ESSENTIAL READS: SCREENING FOR PERINATAL ANXIETY DISORDERS This 31-item questionnaire is easy to complete and score, is sensitive to how anxiety presents in perinatal women and may be used in a variety of settings. This scale assesses four categories of anxiety: (1) acute anxiety and adjustment, (2) general worry and specific fears, (3) perfectionism, control and trauma and (4) social anxiety. THE EFFECTS OF MARIJUANA ON EMBRYO DEVELOPMENT Disruption of these tightly regulated signaling pathways by exogenous cannabinoids may have a number of downstream adverse effects on: (1) Obstetrical Outcomes (ie., preimplantation and implantation), and (2) Embryo Development (ie., direct effects on the fetus). SLEEP PROBLEMS IN MENOPAUSAL WOMEN Sleep Problems in Menopausal Women. Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primarysleep disorder.
MORE MIDLIFE WOMEN USING CANNABIS TO MANAGE PERIMENOPAUSAL According to a study results presented during the 2020 Virtual Annual Meeting of The North American Menopause Society (NAMS), more perimenopausal women may be considering the use of cannabis for the management of their menopausal symptoms. In a survey of 232 women (average age 56 years) participating in the Midlife Women VeteransHealth Survey
POST TRAUMATIC STRESS DISORDER AND PREGNANCY Understanding post traumatic stress disorder (PTSD) during pregnancy is important given that PTSD is relatively common and persistent in nature. PTSD will occur in approximately 10% of women in their lifetime, with one-third of episodes lasting more than five years. Given the relatively high prevalence of PTSD in young women and thechronic
TIMING OF POSTPARTUM DEPRESSION ONSET MAY PREDICT SYMPTOM Postpartum depression (PPD) is a common and complicated illness, affecting about 15% of women in the perinatal period. Recent research from the PACT consortium (Postpartum Depression: Action Toward Causes and Treatment) has sought to classify the many potential subtypes of this heterogenous illness and has found emerging differences in time of onset, severity, comorbid anxiety, INTERMITTENT DOSING OF SSRIS FOR PMS Intermittent Dosing of SSRIs for PMS. Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression and anxiety that occur during the 1-2 weeks before the menstrual period but may also help alleviate FLUVOXAMINE AND PREGNANCY: IS THERE A RIGHT CHOICE? A summary of the data from these studies is above. While these studies are indeed reassuring in regards to the risk of congenital malformations with exposure to fluvoxamine during pregnancy, they highlight how infrequently fluvoxamine is used in pregnancy compared to the other SSRIs and, subsequently, how relatively few exposures we have for fluvoxamine in pregnancy compared to IS IT SAFE TO TAKE ADHD MEDICATIONS WHILE BREASTFEEDING In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ECT FOR THE TREATMENT OF SEVERE POSTPARTUM DEPRESSION Ultra-Brief ECT for the Treatment of Severe Postpartum Depression. This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ECT FOR THE TREATMENT OF SEVERE POSTPARTUM DEPRESSION Ultra-Brief ECT for the Treatment of Severe Postpartum Depression. This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. BIPOLAR DISORDER AND THE MENOPAUSAL TRANSITION Bipolar Disorder and the Menopausal Transition. Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder. At the American Psychiatric Association’s 2014 AnnualMeeting
ESSENTIAL READS: SCREENING FOR PERINATAL ANXIETY DISORDERS This 31-item questionnaire is easy to complete and score, is sensitive to how anxiety presents in perinatal women and may be used in a variety of settings. This scale assesses four categories of anxiety: (1) acute anxiety and adjustment, (2) general worry and specific fears, (3) perfectionism, control and trauma and (4) social anxiety. THE EFFECTS OF MARIJUANA ON EMBRYO DEVELOPMENT Disruption of these tightly regulated signaling pathways by exogenous cannabinoids may have a number of downstream adverse effects on: (1) Obstetrical Outcomes (ie., preimplantation and implantation), and (2) Embryo Development (ie., direct effects on the fetus). SLEEP PROBLEMS IN MENOPAUSAL WOMEN Sleep Problems in Menopausal Women. Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primarysleep disorder.
MORE MIDLIFE WOMEN USING CANNABIS TO MANAGE PERIMENOPAUSAL According to a study results presented during the 2020 Virtual Annual Meeting of The North American Menopause Society (NAMS), more perimenopausal women may be considering the use of cannabis for the management of their menopausal symptoms. In a survey of 232 women (average age 56 years) participating in the Midlife Women VeteransHealth Survey
POST TRAUMATIC STRESS DISORDER AND PREGNANCY Understanding post traumatic stress disorder (PTSD) during pregnancy is important given that PTSD is relatively common and persistent in nature. PTSD will occur in approximately 10% of women in their lifetime, with one-third of episodes lasting more than five years. Given the relatively high prevalence of PTSD in young women and thechronic
TIMING OF POSTPARTUM DEPRESSION ONSET MAY PREDICT SYMPTOM Postpartum depression (PPD) is a common and complicated illness, affecting about 15% of women in the perinatal period. Recent research from the PACT consortium (Postpartum Depression: Action Toward Causes and Treatment) has sought to classify the many potential subtypes of this heterogenous illness and has found emerging differences in time of onset, severity, comorbid anxiety, INTERMITTENT DOSING OF SSRIS FOR PMS Intermittent Dosing of SSRIs for PMS. Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression and anxiety that occur during the 1-2 weeks before the menstrual period but may also help alleviate FLUVOXAMINE AND PREGNANCY: IS THERE A RIGHT CHOICE? A summary of the data from these studies is above. While these studies are indeed reassuring in regards to the risk of congenital malformations with exposure to fluvoxamine during pregnancy, they highlight how infrequently fluvoxamine is used in pregnancy compared to the other SSRIs and, subsequently, how relatively few exposures we have for fluvoxamine in pregnancy compared to IS IT SAFE TO TAKE ADHD MEDICATIONS WHILE BREASTFEEDING In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may FERTILITY AND MENTAL HEALTH The stress of the non-fulfillment of a wish for a child has been associated with emotional sequelae such as anger, depression, anxiety, marital problems, sexual dysfunction, and social isolation. Couples experience stigma, sense of loss, and diminished self-esteem in EXPERT GUIDELINES FOR THE TREATMENT OF PMDD In this review, guidelines for the treatment of PMDD are provided. Selective serotonin reuptake inhibitors (SSRIs) are the most widely used pharmacologic agents for treating depression and anxiety disorders, and several have also emerged as first-line treatment for premenstrual dysphoric disorder (PMDD). VENLAFAXINE (EFFEXOR) FOR POSTMENOPAUSAL HOT FLUSHESSEE MORE ON WOMENSMENTALHEALTH.ORG ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. POSTPARTUM SPECIFIC ANXIETY SCALE: A NEW INSTRUMENT FOR Several studies suggest that postpartum anxiety is relatively common among postpartum women and may even be more common than depression. Emerging evidence also suggests that a large number of postpartum women who do not meet diagnostic criteria for a specific anxiety disorder yet experience a clinically significant anxiety symptoms which are distinct from anxiety experienced at other times of IS DULOXETINE (CYMBALTA) SAFE TO USE DURING PREGNANCY? Although it is used fairly commonly in women of child-bearing age, information regarding its reproductive safety is limited. For those of you interested, there is a thorough review on the use of duloxetine during pregnancy in the December 2014 issue of the Journal of Clinical Psychiatry . I will summarize here the points made in this review. DOES DEPO-PROVERA CAUSE MOOD CHANGES? Potential side effects of DMPA include bone density loss, weight gain, and mood worsening. Although depression is listed in the packet insert as a side effect of the injection, available research addressing this side effect are limited and contradictory. In two older studies, between 1% and 5% of DMPA users reported experiencing depression or CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may FERTILITY AND MENTAL HEALTH The stress of the non-fulfillment of a wish for a child has been associated with emotional sequelae such as anger, depression, anxiety, marital problems, sexual dysfunction, and social isolation. Couples experience stigma, sense of loss, and diminished self-esteem in EXPERT GUIDELINES FOR THE TREATMENT OF PMDD In this review, guidelines for the treatment of PMDD are provided. Selective serotonin reuptake inhibitors (SSRIs) are the most widely used pharmacologic agents for treating depression and anxiety disorders, and several have also emerged as first-line treatment for premenstrual dysphoric disorder (PMDD). VENLAFAXINE (EFFEXOR) FOR POSTMENOPAUSAL HOT FLUSHESSEE MORE ON WOMENSMENTALHEALTH.ORG ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. POSTPARTUM SPECIFIC ANXIETY SCALE: A NEW INSTRUMENT FOR Several studies suggest that postpartum anxiety is relatively common among postpartum women and may even be more common than depression. Emerging evidence also suggests that a large number of postpartum women who do not meet diagnostic criteria for a specific anxiety disorder yet experience a clinically significant anxiety symptoms which are distinct from anxiety experienced at other times of IS DULOXETINE (CYMBALTA) SAFE TO USE DURING PREGNANCY? Although it is used fairly commonly in women of child-bearing age, information regarding its reproductive safety is limited. For those of you interested, there is a thorough review on the use of duloxetine during pregnancy in the December 2014 issue of the Journal of Clinical Psychiatry . I will summarize here the points made in this review. DOES DEPO-PROVERA CAUSE MOOD CHANGES? Potential side effects of DMPA include bone density loss, weight gain, and mood worsening. Although depression is listed in the packet insert as a side effect of the injection, available research addressing this side effect are limited and contradictory. In two older studies, between 1% and 5% of DMPA users reported experiencing depression orFOR PROVIDERS
Online Resources The American College of Obstetricians and Gynecologists ACOG provides a FAQs sheet on perinatal depression and offers a list of resources for patients and clinicals. DART - Developmental and Reproductive Toxicology Database DART provides more than 400,000 journal references covering teratology and other aspects of developmental and reproductive toxicology. LactMed - Drugs and CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
BIPOLAR DISORDER AND THE MENOPAUSAL TRANSITION Bipolar Disorder and the Menopausal Transition. Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder. At the American Psychiatric Association’s 2014 AnnualMeeting
CLINICAL UPDATE 2019: TAMOXIFEN AND ANTIDEPRESSANTS Clinical Update 2019: Tamoxifen and Antidepressants. Women receiving tamoxifen for the treatment or prevention of breast cancer should be aware of possible drug-drug interactions between tamoxifen and specific antidepressant medications. Antidepressants are used widely to treat depression and anxiety disorders in midlife women. ANXIETY DURING PREGNANCY: HOW DOES IT AFFECT THE During fetal life, neurons proliferate, migrate and form connections, providing the structure of the developing brain. Neurons reach their final destinations by the 16th week of gestation, while branching and making appropriate connections occur even before that time (1). The brain continues to develop during the entire pregnancy, with most of the synapse formation in the developing brain POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. SLEEP PROBLEMS IN MENOPAUSAL WOMEN Sleep Problems in Menopausal Women. Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primarysleep disorder.
HOW DO WE RESPOND TO MOTHERS WHO USE DRUGS DURING The American College of Obstetricians and Gynecologists (ACOG) recommends universal screening to be carried out at the first prenatal visit. Providers should assess all patients regarding their use of substances with a a validated verbal screening tool, such as the 4Ps, NIDA Quick Screen, and CRAFFT (for women 26 years or younger). DESVENLAFAXINE FOR THE TREATMENT OF MENOPAUSAL HOT FLUSHES Desvenlafaxine for the Treatment of Menopausal Hot Flushes. Last Friday, Wyeth received FDA approval for the antidepressant desvenlafaxine succinate (marketed under the name Pristiq), a metabolite of venlafaxine or Effexor. Although this drug was approved for the treatment of major depression, a recent study has demonstratedthat desvenlafaxine
PREMENSTRUAL DYSPHORIC DISORDER: A GUIDE FOR PATIENTS … the onset of symptoms with a reproductive event, such as a baby’s birth or surgery for tubal ligation. Premenstrual symptoms do not occur when a woman is pregnant, breast- CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. SLEEP PROBLEMS IN MENOPAUSAL WOMEN Sleep Problems in Menopausal Women. Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primarysleep disorder.
SUICIDE ATTEMPTS MORE COMMON DURING POSTPARTUM PERIOD, AND While we have abundant data to demonstrate that the postpartum period is a time of increased vulnerability to psychiatric illness in women, it has been much more difficult to generate data estimating the risk of suicide during pregnancy and the postpartum period. VENLAFAXINE (EFFEXOR) FOR POSTMENOPAUSAL HOT FLUSHESSEE MORE ON WOMENSMENTALHEALTH.ORG CENTER FOR WOMEN'S MENTAL HEALTH AT MGHABOUTSPECIALTY AREASBLOGCLINICAL PROGRAMRESEARCH PROGRAMRESOURCES Welcome to The Ammon-Pinizzotto Center for Women’s Mental Health at MGH. Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of the Center. This website provides a range of current information including discussion of new research findings in women’s mental ESSENTIAL READS: BREASTFEEDING AND ADHD MEDICATIONS In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
CLINICAL UPDATE 2020: MELATONIN AND PREGNANCY Clinical Update 2020: Melatonin and Pregnancy. Many women experience some degree of sleep disturbance during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Sleep disturbance is not only distressing but there is now evidence that sleep disturbance during pregnancy may CLINICAL UPDATE 2020: DULOXETINE AND PREGNANCY Clinical Update 2020: Duloxetine and Pregnancy. Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. For many years, we have typically recommended the older antidepressants, including the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine (Prozac),citalopram (Celexa
POSTPARTUM PSYCHOSIS: 10 THINGS YOU NEED TO KNOW Disorganized, unusual behavior and obsessive thoughts related to the infant frequently occur. Postpartum psychosis often has a delirium-like presentation, with symptoms of disorientation, derealization, and depersonalization. Postpartum psychosis is associated with an increased risk of both suicide and infanticide. ORAL CONTRACEPTIVES AND LAMOTRIGINE (LAMICTAL) BLOOD LEVELS Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels. Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population. OVARIAN SUPPRESSION FOR PMDD: NEW STUDY SUGGESTS LONG-TERM The current study indicates that ovarian suppression with leuprolide may actually be a viable and effective long-term treatment option for women with PMDD and that estrogen and progesterone addback may, despite some increased symptoms during the early phases of treatment, be well-tolerated over a longer course of treatment. SLEEP PROBLEMS IN MENOPAUSAL WOMEN Sleep Problems in Menopausal Women. Peri- and post-menopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes; however, a recent study from researchers at Wayne State University School of Medicine suggests that about half of these women may have a primarysleep disorder.
SUICIDE ATTEMPTS MORE COMMON DURING POSTPARTUM PERIOD, AND While we have abundant data to demonstrate that the postpartum period is a time of increased vulnerability to psychiatric illness in women, it has been much more difficult to generate data estimating the risk of suicide during pregnancy and the postpartum period. VENLAFAXINE (EFFEXOR) FOR POSTMENOPAUSAL HOT FLUSHESSEE MORE ON WOMENSMENTALHEALTH.ORG BIPOLAR DISORDER AND THE MENOPAUSAL TRANSITION Bipolar Disorder and the Menopausal Transition. Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder. At the American Psychiatric Association’s 2014 AnnualMeeting
CLINICAL UPDATE 2020: LAMOTRIGINE (LAMICTAL) AND PREGNANCY Clinical Update 2020: Lamotrigine (Lamictal) and Pregnancy. Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree ofteratogenic risk.
STRESS DURING PREGNANCY INCREASES ADHD RISK Stress During Pregnancy Increases ADHD Risk. While genetic factors are clearly important in determining a child’s risk for attention deficit hyperactivity disorder (ADHD), recent studies have investigated the link between exposure to certain maternal behaviors during pregnancy, such as smoking and alcohol use, and the risk ofdeveloping
ALCOHOL AND PREGNANCY: ATTITUDES AROUND THE GLOBE According to the Center for Disease Control, one in 10 (10.2%) of pregnant women in the United States reports drinking alcohol in the past 30 days. In addition, 3.1% of pregnant women report binge drinking – 4 or more alcoholic beverages on one occasion. A recent study looked at 7000 women in 11 European countries assessed theproportion of
POST TRAUMATIC STRESS DISORDER AND PREGNANCY Understanding post traumatic stress disorder (PTSD) during pregnancy is important given that PTSD is relatively common and persistent in nature. PTSD will occur in approximately 10% of women in their lifetime, with one-third of episodes lasting more than five years. Given the relatively high prevalence of PTSD in young women and thechronic
PREGNANCY OUTCOMES IN WOMEN WITH ANOREXIA NERVOSA Current research on pregnancy outcomes in women with anorexia nervosa has yielded conflicting results. While some studies report an increased risk of cesarean delivery, miscarriage, preterm birth, and small?for?gestational age birth in this population, others find noassociation.
DESVENLAFAXINE FOR THE TREATMENT OF MENOPAUSAL HOT FLUSHES Desvenlafaxine for the Treatment of Menopausal Hot Flushes. Last Friday, Wyeth received FDA approval for the antidepressant desvenlafaxine succinate (marketed under the name Pristiq), a metabolite of venlafaxine or Effexor. Although this drug was approved for the treatment of major depression, a recent study has demonstratedthat desvenlafaxine
THE EFFECTS OF MARIJUANA ON EMBRYO DEVELOPMENT Disruption of these tightly regulated signaling pathways by exogenous cannabinoids may have a number of downstream adverse effects on: (1) Obstetrical Outcomes (ie., preimplantation and implantation), and (2) Embryo Development (ie., direct effects on the fetus). FLUVOXAMINE AND PREGNANCY: IS THERE A RIGHT CHOICE? A summary of the data from these studies is above. While these studies are indeed reassuring in regards to the risk of congenital malformations with exposure to fluvoxamine during pregnancy, they highlight how infrequently fluvoxamine is used in pregnancy compared to the other SSRIs and, subsequently, how relatively few exposures we have for fluvoxamine in pregnancy compared to IS IT SAFE TO TAKE ADHD MEDICATIONS WHILE BREASTFEEDING In 2003, 0.9% of women between the ages of 15 and 44 filled a prescription for an ADHD medication, compared to 4.0% of women in 2015. As a result of this shift, we are seeing more women in our clinic with questions regarding the reproductive safety of stimulants during pregnancy and the postpartum period. In previous posts, we haveaddressed
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* Subscribe to Our Newsletter * Support Our Program Women's Mental Health Across the Life Cycle PMDD/PMS with functioning & quality of life When PMS symptoms interfere Weighing the risks & benefits of pharmacologic treatment during pregnancy Psychiatric Disorders During Pregnancy Postpartum Psychiatric Disorders depression do not receive adequate care Most women suffering from postpartum Breastfeeding & take medications and breastfeed? How safe is it for women to Psychiatric Medications Fertility & Mental Health with infertility and its treatment Stress, depression, and anxiety associated What are safe treatments for symptomatic Depression, hot flashes, sleep disturbance… Menopausal Symptoms midlife women? Welcome to the MGH Center for Women’s Mental HealthMGH Center for Women's Mental Health 2020-05-05T11:01:36-04:00 WELCOME TO THE AMMON-PINIZZOTTO CENTER FOR WOMEN’S MENTAL HEALTHAT
MGH.
Our Center, established in 1989, has been renamed following the generous gift from Carol Ammon and Dr. Marie Pinizzotto. These resources will be used to realize the overarching mission of theCenter .
This website provides a range of current information including discussion of new research findings in women’s mental health and how such investigations inform day-to-day clinical practice. Despite the growing number of studies being conducted in women’s health, the clinical implications of such work are frequently controversial, leaving patients with questions regarding the most appropriate path to follow. Providing these resources to patients and their doctors so that individual clinical decisions can be made in a thoughtful and collaborative fashion dovetails with the mission of our Center. LATEST FROM THE BLOG*
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WEEKLY ROUNDUP FOR MAY 16, 2020: RECENT PUBLICATIONS IN WOMEN’SMENTAL HEALTH
MGH Center for Women's Mental Health 2020-05-17T10:06:29-04:00May17th, 2020|
Every week we review the most recent publications in women’s mental health, covering topics relatedRead More
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NEW STUDY ESTIMATES THE ASTONISHING COST OF NEGLECTED PERINATAL MOOD AND ANXIETY DISORDERS IN US MOTHERS MGH Center for Women's Mental Health 2020-05-11T11:42:20-04:00May13th, 2020|
A recently published article in the American Journal of Public Health has attributed a substantialRead More
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LONG-TERM OUTCOMES OF POSTPARTUM PSYCHOSIS: WHAT IS THE RISK OFRECURRENCE?
MGH Center for Women's Mental Health 2020-05-06T15:13:12-04:00May6th, 2020|
Postpartum psychosis is the most severe form of postpartum psychiatric illness. It is a rareRead More
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PREGNANCY REGISTRY
FOR PSYCHIATRIC MEDICATIONS: All pregnant women between the ages of 18-45 with a history of psychiatric illness are eligible to enroll in the registry.LEARN MORE
MGH PERINATAL DEPRESSION SCALE MOBILE APP Are you pregnant? Do you own a smart phone? Get the MGH Perinatal Depression Scale app.LEARN MORE
RESEARCH STUDIES
A NEUROSTEROID INTERVENTION FOR MENOPAUSAL AND PERIMENOPAUSALDEPRESSION
Are you experiencing symptoms of menopause and feeling depressed or down? You may be eligible for a research study at Massachusetts General Hospital evaluating how a medication treats menopausal depression and other symptoms of menopause. NATIONAL PREGNANCY REGISTRY FOR PSYCHIATRIC MEDICATIONS The NATIONAL PREGNANCY REGISTRY FOR PSYCHIATRIC MEDICATIONS is dedicated to evaluating the safety of psychiatric medications such as antidepressants, stimulants, and atypical antipsychotics that many women take during pregnancy to treat a wide range of mood, anxiety, or psychiatric disorders. TO PARTICIPATE CALL TOLL-FREE:1-866-961-2388
MGH POSTPARTUM PSYCHOSIS PROJECT (MGHP3) If you are a mother who has experienced an episode of postpartum psychosis within the past ten years, you could help us to better understand this disorder. Researchers at Massachusetts General Hospital’s (MGH) Ammon-Pinizzotto Center for Women’s Mental Health are announcing the launch of a new research study called the MGH Postpartum Psychosis Project (MGHP3). UPWARD & UPWARD(S) – PREVENTING DEPRESSIVE RELAPSE IN PREGNANCY ANDTHE POST-PARTUM
People who have been depressed in the past are at risk of becoming depressed in the future, and depression during pregnancy is all too common. Our study seeks to determine whether a digital mindfulness-based cognitive therapy (MBCT) platform is effective in preventing depressive relapse during pregnancy and the post-partumperiod.
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WHEN PMS SYMPTOMS INTERFERE WITH FUNCTIONING AND QUALITY OF LIFE FERTILITY & MENTAL HEALTH STRESS, DEPRESSION, AND ANXIETY ASSOCIATED WITH INFERTILITY AND ITSTREATMENT
PSYCHIATRIC DISORDERS DURING PREGNANCY WEIGHING THE RISKS AND BENEFITS OF PHARMACOLOGIC TREATMENT DURINGPREGNANCY
POSTPARTUM PSYCHIATRIC DISORDERS MOST WOMEN SUFFERING FROM POSTPARTUM DEPRESSION DO NOT RECEIVEADEQUATE CARE
BREASTFEEDING & PSYCHIATRIC MEDICATIONS HOW SAFE IS IT FOR WOMEN TO TAKE MEDICATIONS AND BREASTFEED?MENOPAUSAL SYMPTOMS
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