For women with serious conditions, medication may be the best route, but 'talk therapy' may alleviate suffering for others, according to a document prepared by two national physicians groups.
For the nearly one in four women who experience symptoms of depression during pregnancy, physicians on the front lines have long had little more than a prescription for antidepressants and a massive dose of uncertainty to offer.
The result: At last count, roughly 13% of pregnant women in the United States took antidepressant medications at some point in their pregnancy -- often with little to guide them in weighing the risks the drugs may pose to their fetus against the misery and dangers of untreated depression.
In a bid to resolve that conundrum, two of the nation's leading physicians groups have issued the first guidelines for the treatment of depression during pregnancy.
READ MORE @ LOS ANGELES TIMES
Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts
Thursday, September 17, 2009
Friday, August 21, 2009
Pregnant, depressed and confused? New guidelines clarify antidepressant risks, benefits
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Booster Shots
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Pregnant, depressed and confused? New guidelines clarify antidepressant risks, benefits
August 21, 2009 | 5:00 pm
Depression hits women in the childbearing years more than any other demographic, but how to deal with this most common of mental afflictions poses a conundrum: antidepressant medications have become the first line of defense against depression; but there's growing research evidence that they pose risks to a developing fetus.
It's a tightrope that obstetricians on the front lines of patient care have walked for years without guidance from their own leaders or the profession of psychiatry. Busy, concerned but operating in unfamiliar terrain, many obstetricians have pulled out their pads, written a prescription for an antidepressant, and hoped for the best. No surprise, then, that by 2003, 13% of pregnant women had taken an antidepressant at some point in their http://latimesblogs.latimes.com/booster_shots/2009/08/pregnant-depressed-and-confused-new-guidelines-clarify-antidepressant-risks-benefits.html -- twice the rate that was seen in 1999.
But on Friday, the American Psychiatric Assn. and the American College of Obstetricians and Gynecologists put a safety net under obstetricians and the pregnant women they treat. In a first-ever set of guidelines, the two physician groups offered obstetricians and their patients a set of clear road maps for treating depression in pregnancy.
The guidelines were published simultaneously in the ACOG journal Obstetrics and Gynecology and in the APA's journal, General Hospital Psychiatry.
READ MORE @ LOS ANGELES TIMES
Booster Shots
Oddities, musings and news from
the world of health
« Previous Post | Booster Shots Home | Next Post »
Pregnant, depressed and confused? New guidelines clarify antidepressant risks, benefits
August 21, 2009 | 5:00 pm
Depression hits women in the childbearing years more than any other demographic, but how to deal with this most common of mental afflictions poses a conundrum: antidepressant medications have become the first line of defense against depression; but there's growing research evidence that they pose risks to a developing fetus.
It's a tightrope that obstetricians on the front lines of patient care have walked for years without guidance from their own leaders or the profession of psychiatry. Busy, concerned but operating in unfamiliar terrain, many obstetricians have pulled out their pads, written a prescription for an antidepressant, and hoped for the best. No surprise, then, that by 2003, 13% of pregnant women had taken an antidepressant at some point in their http://latimesblogs.latimes.com/booster_shots/2009/08/pregnant-depressed-and-confused-new-guidelines-clarify-antidepressant-risks-benefits.html -- twice the rate that was seen in 1999.
But on Friday, the American Psychiatric Assn. and the American College of Obstetricians and Gynecologists put a safety net under obstetricians and the pregnant women they treat. In a first-ever set of guidelines, the two physician groups offered obstetricians and their patients a set of clear road maps for treating depression in pregnancy.
The guidelines were published simultaneously in the ACOG journal Obstetrics and Gynecology and in the APA's journal, General Hospital Psychiatry.
READ MORE @ LOS ANGELES TIMES
Sunday, July 19, 2009
Depression Poses Pregnancy Risks
Thanks to high-profile celebrities like Brooke Shields, postpartum depression is out of the closet and discussed as something to recognize and treat.
But less well known is depression during pregnancy -- a common problem as well, and one that also can be risky for the unborn baby, experts now know.
A depressed woman, for instance, is more likely to give birth early, increasing health risks for the baby.
Depression during pregnancy is more common than most people believe, agree Dr. De-Kun Li, a reproductive perinatal epidemiologist in the research division at Kaiser Permanente in Oakland, Calif., and Dr. Diana Dell, a psychiatrist and obstetrician-gynecologist at Duke University Medical Center in Durham, N.C.
One or two of every 10 pregnant women have symptoms of major depression, according to the March of Dimes. Those who have had a bout of depression before are more likely to get it again. And Li said that others might have depressive symptoms -- short of clinical depression but still bothersome and unhealthy.
READ MORE @ ATLANTA JOURNAL CONSTITUTION
But less well known is depression during pregnancy -- a common problem as well, and one that also can be risky for the unborn baby, experts now know.
A depressed woman, for instance, is more likely to give birth early, increasing health risks for the baby.
Depression during pregnancy is more common than most people believe, agree Dr. De-Kun Li, a reproductive perinatal epidemiologist in the research division at Kaiser Permanente in Oakland, Calif., and Dr. Diana Dell, a psychiatrist and obstetrician-gynecologist at Duke University Medical Center in Durham, N.C.
One or two of every 10 pregnant women have symptoms of major depression, according to the March of Dimes. Those who have had a bout of depression before are more likely to get it again. And Li said that others might have depressive symptoms -- short of clinical depression but still bothersome and unhealthy.
READ MORE @ ATLANTA JOURNAL CONSTITUTION
Tuesday, March 17, 2009
Pitt Study Of Pregnant Women Shows Antidepressants, Depression May Raise Risk Of Premature Birth
Pregnant women who had untreated major depression in all three trimesters of pregnancy, as well as those who took certain antidepressants, had preterm birth rates exceeding 20 percent, according to a study by University of Pittsburgh School of Medicine researchers published in the March issue of American Journal of Psychiatry.
Approximately 10-to-20 percent of women struggle with symptoms of major depression during their pregnancies, but treating it can be complicated. Selective serotonin reuptake inhibitor (SSRI) antidepressants are usually the first line of depression treatment, but can lead to unwanted outcomes such as preterm births if used continuously throughout pregnancy, the findings suggest.
READ MORE @ MEDICAL NEWS TODAY
Approximately 10-to-20 percent of women struggle with symptoms of major depression during their pregnancies, but treating it can be complicated. Selective serotonin reuptake inhibitor (SSRI) antidepressants are usually the first line of depression treatment, but can lead to unwanted outcomes such as preterm births if used continuously throughout pregnancy, the findings suggest.
READ MORE @ MEDICAL NEWS TODAY
Wednesday, February 25, 2009
Diabetic pregnant women at risk for depression
Low-income pregnant women and new mothers with diabetes are nearly twice as likely as those without diabetes to be diagnosed with depression during and after pregnancy, new research indicates.
Depression during the last several months of pregnancy and the year following childbirth -- the so-called perinatal period -- affects at least 10 percent to 12 percent of new mothers, and approximately 2 percent to 9 percent of pregnancies are complicated by diabetes, the researchers note. Past research has established an association between diabetes and depression in the general adult population.
In the current study, Dr. Bernard L. Harlow, at the University of Minnesota, Minneapolis, and colleagues examined the association between diabetes and depression in the perinatal period among approximately 11,000 low-income women enrolled in Medicaid who gave birth between 2004 and 2006.
They found that women with diabetes had nearly double the odds of having a diagnosis of depression or taking an antidepressant during the perinatal period compared with women without diabetes (15.2 percent versus 8.5 percent).
READ MORE @ REUTERS
Depression during the last several months of pregnancy and the year following childbirth -- the so-called perinatal period -- affects at least 10 percent to 12 percent of new mothers, and approximately 2 percent to 9 percent of pregnancies are complicated by diabetes, the researchers note. Past research has established an association between diabetes and depression in the general adult population.
In the current study, Dr. Bernard L. Harlow, at the University of Minnesota, Minneapolis, and colleagues examined the association between diabetes and depression in the perinatal period among approximately 11,000 low-income women enrolled in Medicaid who gave birth between 2004 and 2006.
They found that women with diabetes had nearly double the odds of having a diagnosis of depression or taking an antidepressant during the perinatal period compared with women without diabetes (15.2 percent versus 8.5 percent).
READ MORE @ REUTERS
Thursday, December 25, 2008
Birth Defects and SSRIs—How's a Mother to Know?
In 2006, Elissa's doctor prescribed Cymbalta to help with her depression. Shortly after starting on the antidepressant Elissa became pregnant. On her doctor's advice she continued taking Cymbalta. But it soon became apparent her baby was developing life-threatening defects.
"I had my first ultrasound at 3 months," Elissa said. "That's when I found out something wasn't right. The doctor explained that my baby appeared to have a heart defect, a hole in her heart. Shortly after Elissa's baby girl was born, prematurely, the infant had to undergo heart surgery to repair the damage that could have been induced by the antidepressant. But Elissa was not aware of the association between SSRIs—or selective serotonin reuptake inhibitors—and birth defects.
READ MORE @ LAWYERS AND SETTLEMENTS
"I had my first ultrasound at 3 months," Elissa said. "That's when I found out something wasn't right. The doctor explained that my baby appeared to have a heart defect, a hole in her heart. Shortly after Elissa's baby girl was born, prematurely, the infant had to undergo heart surgery to repair the damage that could have been induced by the antidepressant. But Elissa was not aware of the association between SSRIs—or selective serotonin reuptake inhibitors—and birth defects.
READ MORE @ LAWYERS AND SETTLEMENTS
Thursday, November 27, 2008
Two Antidepressants Taken During Pregnancy Linked To Heart Anomalies In Babies
Women who took the antidepressant fluoxetine during the first three months of pregnancy gave birth to four times as many babies with heart problems as women who did not and the levels were three times higher in women taking paroxetine.
Although some of the conditions were serious, others were not severe and resolved themselves without the need for medical intervention, according to a three-country study in the November issue of the British Journal of Clinical Pharmacology.
Researchers have advised women taking the drugs to continue unless they are advised to stop by their doctor or consultant. But they are being urged to give up smoking, as the study also found that more than ten cigarettes a day was associated with a five-fold increase in babies with major heart problems.
The team has also suggested that women on fluoxetine should be given a foetal echocardiogram in their second trimester to diagnose possible heart anomalies.
READ MORE @ SCIENCE DAILY
Although some of the conditions were serious, others were not severe and resolved themselves without the need for medical intervention, according to a three-country study in the November issue of the British Journal of Clinical Pharmacology.
Researchers have advised women taking the drugs to continue unless they are advised to stop by their doctor or consultant. But they are being urged to give up smoking, as the study also found that more than ten cigarettes a day was associated with a five-fold increase in babies with major heart problems.
The team has also suggested that women on fluoxetine should be given a foetal echocardiogram in their second trimester to diagnose possible heart anomalies.
READ MORE @ SCIENCE DAILY
Friday, July 4, 2008
Antidepressants: Weighing the Decision
It's almost the definition of a good mother: someone who puts her child's welfare ahead of her own. So women may agonize if they are pregnant and must decide whether to accept a treatment that could help them but harm their fetus. As many as 20 percent of pregnant women experience significant depression. Stopping antidepressant medication during pregnancy may increase the risk of relapse for the mom, but some drugs may hold dangers for the fetus. What's a mother to do?
The answer is to focus on the right issues. Just as no medical treatment is without risk or potential discomfort, doing nothing also carries risks and discomforts. Try not to overreact to scary news accounts; instead, look at your own situation carefully. Since the sources of depression are very varied, learn as much as you can about the nature of your depression. For example, depression varies in intensity and may disturb sleep or appetite, or interfere with functioning. Mood may be constantly mildly low, or there may be shorter, more severe episodes with relatively normal periods in between. Any amount of distress is worth reporting to your doctor.
Data from decades of research on treatment are reassuring. Until recently, most data have shown that exposing a fetus to antidepressants has not increased the risk of birth defects. The FDA did circulate a warning recently about the drug paroxetine but is still studying it and has not yet issued a final recommendation.
READ MORE @ NEWSWEEK
The answer is to focus on the right issues. Just as no medical treatment is without risk or potential discomfort, doing nothing also carries risks and discomforts. Try not to overreact to scary news accounts; instead, look at your own situation carefully. Since the sources of depression are very varied, learn as much as you can about the nature of your depression. For example, depression varies in intensity and may disturb sleep or appetite, or interfere with functioning. Mood may be constantly mildly low, or there may be shorter, more severe episodes with relatively normal periods in between. Any amount of distress is worth reporting to your doctor.
Data from decades of research on treatment are reassuring. Until recently, most data have shown that exposing a fetus to antidepressants has not increased the risk of birth defects. The FDA did circulate a warning recently about the drug paroxetine but is still studying it and has not yet issued a final recommendation.
READ MORE @ NEWSWEEK
Sunday, May 25, 2008
No Link Found Between Antidepressants And Birth Defects, According To New Study
Expectant mothers can safely use prescribed antidepressants during their first trimester, according to a new study from the Université de Montréal and Ste. Justine Hospital published in the May edition of the British Journal of Psychiatry.
Dr. Anick Bérard and her team found that antidepressants have no effect on foetal development. "This is the first study to investigate the impact of antidepressant use during the first trimester of pregnancy in mothers with psychiatric disorders," she said. "In terms of birth malformations in this population, we found no difference between women who used antidepressants and those who did not use antidepressants during their first trimester.
READ MORE @ SCIENCE DAILY
Dr. Anick Bérard and her team found that antidepressants have no effect on foetal development. "This is the first study to investigate the impact of antidepressant use during the first trimester of pregnancy in mothers with psychiatric disorders," she said. "In terms of birth malformations in this population, we found no difference between women who used antidepressants and those who did not use antidepressants during their first trimester.
READ MORE @ SCIENCE DAILY
Sunday, January 20, 2008
Should Bipolar Medication Be Halted During Pregnancy?
When faced with pregnant women who have bipolar disorder, clinicians are urged to balance carefully the potential harm of medication to the fetus and the high risk of recurrent mood episodes in the mother.
Pregnant women with bipolar disorder and their physicians face a dilemma: stay on mood-stabilizing medications, which carry risks of causing birth defects, or discontinue the medications and brace for the possibility of relapse.
The possibility of relapse due to interrupted pharmacotherapy has been quantified in a study published in the December 2007 American Journal of Psychiatry, which warns that pregnant women with bipolar disorder who discontinue mood stabilizers are much more likely to suffer the return of their illness than those who continue taking the medications.
READ MORE @ PSYCHIATRIC NEWS
Pregnant women with bipolar disorder and their physicians face a dilemma: stay on mood-stabilizing medications, which carry risks of causing birth defects, or discontinue the medications and brace for the possibility of relapse.
The possibility of relapse due to interrupted pharmacotherapy has been quantified in a study published in the December 2007 American Journal of Psychiatry, which warns that pregnant women with bipolar disorder who discontinue mood stabilizers are much more likely to suffer the return of their illness than those who continue taking the medications.
READ MORE @ PSYCHIATRIC NEWS
Thursday, November 1, 2007
Use of Antidepressants in Pregnancy Affects Neonatal Outcomes: Presented at AACAP
Babies born to mothers who take antidepressant medication during pregnancy have high levels of cortisol in cord-blood at birth, and their mothers are more likely to experience delivery complications, according to a study presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).
When examined at 2 weeks of age, the infants of women taking antidepressants demonstrated more tremulousness and were more excitable than infants born to women not taking antidepressants.
The study results were presented by lead author Sheila Marcus, MD, Clinical Associate Professor, Departments of Psychiatry and Depression Center, University of Michigan, Ann Arbor, Michigan, United States, on October 24.
READ MORE @ DOCTOR'S GUIDE
When examined at 2 weeks of age, the infants of women taking antidepressants demonstrated more tremulousness and were more excitable than infants born to women not taking antidepressants.
The study results were presented by lead author Sheila Marcus, MD, Clinical Associate Professor, Departments of Psychiatry and Depression Center, University of Michigan, Ann Arbor, Michigan, United States, on October 24.
READ MORE @ DOCTOR'S GUIDE
Wednesday, August 22, 2007
Prenatal antidepressants linked to preterm births
Antidepressant drug use during pregnancy, but not depression itself, is associated with an increased risk of preterm birth and lower fetal age at delivery, according to results of a study published in the American Journal of Psychiatry.
"Depressive symptoms are not uncommon during pregnancy, and...symptoms may occur more frequently during pregnancy than in the postpartum period," write Dr. Rita Suri and colleagues from the University of California, Los Angeles. Depression during pregnancy and just after delivery "has been associated with low maternal weight gain, increased frequency of cigarette, alcohol, and substance use, and ambivalence about the pregnancy."
To further investigate, the researchers examined the effects of maternal depression and antidepressant drug use on fetal age and risk of preterm birth in a study of 90 pregnant women.
READ MORE @ REUTERS
"Depressive symptoms are not uncommon during pregnancy, and...symptoms may occur more frequently during pregnancy than in the postpartum period," write Dr. Rita Suri and colleagues from the University of California, Los Angeles. Depression during pregnancy and just after delivery "has been associated with low maternal weight gain, increased frequency of cigarette, alcohol, and substance use, and ambivalence about the pregnancy."
To further investigate, the researchers examined the effects of maternal depression and antidepressant drug use on fetal age and risk of preterm birth in a study of 90 pregnant women.
READ MORE @ REUTERS
Friday, June 29, 2007
Antidepressant studies find low birth-defect risk
Use of antidepressants by pregnant women doesn't significantly increase the risk of birth defects, with rare exceptions, two studies found.
The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine.
READ MORE @ BALTIMORE SUN
The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine.
READ MORE @ BALTIMORE SUN
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