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Psychiatric medications in pregnancy

Jessica L Coker, David Catlin, Shona Ray-Griffith, Bettina Knight, Zachary N Stowe
BACKGROUND: The treatment of pregnant women with opioid use disorder is challenging due to the myriad of physical, mental, and social complications. Factors influencing adherence to buprenorphine during pregnancy have not been identified. MATERIALS AND METHODS: Pregnant women with opioid use disorder followed in a tertiary clinic were included in a retrospective chart review from buprenorphine induction through delivery. All women who had been evaluated and treated with buprenorphine from January 1, 2014, to September 31, 2016, were included...
September 15, 2018: Drug and Alcohol Dependence
Amy Gajaria, Arun V Ravindran
BACKGROUND: Perinatal depression has been associated with infant low birth weight and with multiple health indicators affecting childhood morbidity and mortality. The condition is twice as prevalent in low and middle-income countries (LMICs) compared to high-income countries but poorly studied. AIM: To conduct a review of published literature on interventions for perinatal depression in LMICs. METHODS: A search of the literature was performed for articles published up to October 2017...
August 17, 2018: Asian Journal of Psychiatry
Han Wang, Ji-Tao Li, Yue Zhang, Rui Liu, Xiao-Dong Wang, Tian-Mei Si, Yun-Ai Su
Background: With the growing use of second-generation antipsychotics for the treatment of a spectrum of psychiatric illnesses in pregnancy, concerns have been raised about the long-term impact of these medications on offspring neurodevelopment. However, preclinical and clinical evidence on the lasting effects of prenatal antipsychotic exposure is still sparse. Methods: Risperidone, a widely used second-generation antipsychotic, and haloperidol, a representative first-generation antipsychotic, were administered to pregnant C57BL/6N mice from embryonic day 6 to 16...
August 29, 2018: International Journal of Neuropsychopharmacology
Marlene P Freeman, Tiffany Farchione, Lynn Yao, Leyla Sahin, Lockwood Taylor, Krista F Huybrechts, Ruta Nonacs, Alexandra Z Sosinsky, Adele C Viguera, Lee S Cohen
Pregnancy labeling of prescription medications in the US is in the midst of a major transformation. The FDA's previous system, which used letter ratings to convey drug safety, was simple but led to misunderstandings-both faulty assurances and undue concerns. The new system, established under the Pregnancy and Lactation Labeling Rule, aims for more descriptive and up-to-date explanations of risk as well as context needed for informed decision-making based on available data. In April 2017, a conference titled "Pharmacovigilance, Reproductive Safety, and the Pregnancy and Lactation Labeling Rule" brought together clinicians and researchers, FDA officials, and representatives of the public and industry to discuss a host of questions relating to the new system...
July 17, 2018: Journal of Clinical Psychiatry
Maureen Lacy, Samantha DeDios-Stern, Sarah Fredrickson, Shravan Parikh, Todd Nader, David M Frim
This cross-sectional study investigates the prevalence and risks for psychiatric diagnoses in a large cohort of children with Chiari malformation type 1 (CM1) presenting for neurosurgical evaluation. Children between the ages of 6 and 17 years who were evaluated and diagnosed with CM1 at a neurosurgery clinic were identified. Eighty-six participants were recruited for this study with an average age of 11 years. Parents of participants completed a pediatric medical history questionnaire and a semistructured interview regarding the child's psychiatric, developmental, medical, and family history...
August 27, 2018: Pediatric Neurosurgery
Lee S Cohen, Lina Góez-Mogollón, Alexandra Z Sosinsky, Gina M Savella, Adele C Viguera, David Chitayat, Sonia Hernández-Díaz, Marlene P Freeman
OBJECTIVE: Second-generation antipsychotics are commonly prescribed to reproductive-age women for the treatment of a spectrum of psychiatric disorders. Quetiapine is the most commonly prescribed medication in this class, and therefore a better understanding of its reproductive safety profile is critical. The goal of this study was to determine the risk of major malformations among infants exposed to quetiapine during pregnancy compared with a group of infants whose mothers had a history of psychiatric morbidity but who did not use a second-generation antipsychotic during pregnancy...
August 16, 2018: American Journal of Psychiatry
Andrew M Siegel, Vardit Ravitsky
PURPOSE OF REVIEW: This review aims to provide guidance to clinicians facing requests for assisted reproduction from women with mental illness. RECENT FINDINGS: The paper explores the clinical and safety aspects of initiating fertility treatment in this context, including the use of psychotropic medication and the risk of untreated psychiatric mood or psychotic disorders. It also presents the ethical considerations involved in candidate selection, including treating similar cases equitably to avoid biased decisions based solely on "gut-feelings," respect for women's reproductive autonomy, and an effort to protect patients and prospective fetuses/children from harm by employing optimal strategies regarding medication and psychosocial support...
August 9, 2018: Current Psychiatry Reports
Alexandra J Sequeira, Stephanie Buchman, Ariane Lewis, Steven Karceski
Depot medications have been used for long-term treatment of many different medical conditions (schizophrenia, opioid addiction) and for prevention of pregnancy (birth control). In addition, proposals for depot medication for antidepressants have been made as a possible treatment for chronic depression. For the treatment of chronic epilepsy, there are currently no depot antiepileptic drugs (AEDs). However, there may be a role for them. Depot AEDs could improve medication adherence rates, thereby reducing the morbidity and mortality that are associated with ongoing seizures...
August 2018: Epilepsy & Behavior: E&B
Bryna J Harrington, Mina C Hosseinipour, Madalitso Maliwichi, Jacob Phulusa, Allan Jumbe, Shaphil Wallie, Bradley N Gaynes, Joanna Maselko, William C Miller, Brian W Pence
BACKGROUND: Perinatal depression is a common condition of pregnancy and the postpartum period. Depression negatively affects engagement in HIV care, but systematic screening for perinatal depression is not done in most sub-Saharan African countries. Estimating the burden and timing of perinatal depression can help inform medical programs with the current scale-up of HIV care for pregnant women. METHODS: Women (n = 299) initiating antiretroviral therapy for HIV were recruited from a government antenatal clinic in Malawi in 2015-2016 into a cohort study...
October 15, 2018: Journal of Affective Disorders
Marlene P Freeman, Lina Góez-Mogollón, Kathryn A McInerney, Abigail C Davies, Taylor R Church, Alexandra Z Sosinsky, Olivia B Noe, Adele C Viguera, Lee S Cohen
OBJECTIVE: The goal of this analysis was to examine the effect of benzodiazepine use during pregnancy on maternal and neonatal outcomes in a cohort of women with psychiatric disorders. METHODS: 794 evaluable women from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications were followed across pregnancy (N = 144 exposed to benzodiazepines and N = 650 unexposed). Data obtained through maternal report and medical records included maternal outcomes (cesarean section, preeclampsia) and neonatal outcomes (birth weight, breathing difficulty, feeding difficulty, head circumference, 5-minute Apgar score, muscular and/or extrapyramidal symptoms, NICU admission, prematurity)...
July 2018: General Hospital Psychiatry
Eline M P Poels, Lisanne Schrijver, Astrid M Kamperman, Manon H J Hillegers, Witte J G Hoogendijk, Steven A Kushner, Sabine J Roza
Lithium and antipsychotics are often prescribed to treat bipolar disorder or psychotic disorders in women of childbearing age. Little is known about the consequences of these medications during pregnancy for the developing child. The objective of this article is to systematically review findings from preclinical and clinical studies that have examined the neurodevelopmental consequences of intrauterine exposure to lithium and antipsychotics. A systematic search was performed in Embase, Medline, Web of Science, PsychINFO, Cochrane, and Google Scholar...
September 2018: European Child & Adolescent Psychiatry
Angela Lupattelli, Michael J Twigg, Ksenia Zagorodnikova, Myla E Moretti, Mariola Drozd, Alice Panchaud, Andre Rieutord, Romana Gjergja Juraski, Marina Odalovic, Debra Kennedy, Gorazd Rudolf, Herbert Juch, Hedvig Nordeng
Purpose: This study aimed at exploring the prevalence of self-reported antenatal and postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. Materials and methods: This was a multinational web-based study conducted across 12 European countries (n=8069). Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with <1 year of age could participate...
2018: Clinical Epidemiology
Heather Burrell Ward, John A Fromson, Joseph J Cooper, Gildasio De Oliveira, Marcela Almeida
Psychiatric disorders are common in pregnancy, affecting 15-29% of pregnant women. Untreated depression has negative health consequences for mother and fetus. Electroconvulsive therapy (ECT) is an effective option for the treatment of severe depression, high suicide risk, catatonia, medication-resistant illness, psychotic agitation, severe physical decline, and other life-threatening conditions. To our knowledge, however, there is no literature that consolidates all the evidence on maternal and fetal risks associated with untreated depression, medications, and ECT then translating it into one cohesive protocol that could serve as a management guide and a source of reassurance to health-care providers involved in such practice...
May 23, 2018: Archives of Women's Mental Health
Jenny Rangmar, Maria Lilja, Marie Köhler, Antonia Reuter
AIM: This study examined medical and psychosocial risk factors in children born to women with addiction problems during pregnancy and the children's needs for extra medical and psychosocial resources. METHODS: Swedish midwives routinely screen pregnant women for drugs and alcohol and refer women with addictions to the Maternity and Child Healthcare Resource Team. We investigated the medical records of 127 children (51% girls) whose mothers were referred to the Resource Team from 2009 to 2015...
May 21, 2018: Acta Paediatrica
Nadine Zwink, Ekkehart Jenetzky
BACKGROUND: Origin of anorectal malformations (ARM) are considered multifactorial. Several genetic and non-genetic risk factors are discussed in literature. Maternal periconceptional medical drug use as possible risk factor, however, has not been reviewed systematically. METHODS: Studies published between 1977 and April 2017 were reviewed through systematic search in PubMed, ISI Web of Knowledge and Scopus databases. Furthermore, related and cross-referencing publications were reviewed...
May 10, 2018: Orphanet Journal of Rare Diseases
Simriti K Chaudhry, Leah C Susser
BACKGROUND: The prevalence of pregnancy-associated insomnia is high. Although insomnia may flow from normal physiologic features of pregnancy, it may also be an early warning sign of a relapse, or a trigger for a relapse, of a psychiatric illness. Those at risk for psychiatric illnesses may require medications as well as behavioral and psychotherapeutic interventions, to prevent relapse in the perinatal period. Unfortunately, few reviews of psychotropics used to treat pregnancy-related sleep disorders exist...
July 2018: Psychosomatics
Zsuzsa Valasinyovszki, Alexander Kancsev
According to the statistics, there is an increased number of pregnant women taking psychotropic medication. For each clinical decision, or change in therapy that affect women of reproductive age, one has to consider the available information on the reproductive safety of psychiatric drugs. Due to ethical considerations, there are no randomized, double-blind, placebo-controlled studies, hence no unequivocal evidence addressing this topic. When used during pregnancy, there might be potential adverse effects of psychotropic drugs in regards to the following: teratogenicity, pregnancy outcome, obstetrical complications, neonatal toxicity and withdrawal syndrome, breastfeeding, and the offspring's long-term intellectual, behavioral, emotional development...
2018: Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata
Ruoqing Chen, Amanda Regodón Wallin, Eva Norén Selinus, Arvid Sjölander, Katja Fall, Unnur Valdimarsdóttir, Kamila Czene, Fang Fang
OBJECTIVE: To investigate the risk of psychiatric disorders among children of parents with cancer in a nationwide population-based setting. METHODS: Based on Swedish national registers, the study included 101 339 children with parental cancer diagnosed either during pregnancy (N = 1047) or after birth (N = 100 292) that were born during 1983 to 2000. For each exposed child, we randomly selected 10 unexposed children from the general population after individual matching by year of birth and sex...
July 2018: Psycho-oncology
Marlies Onken, Inge Mick, Christof Schaefer
Schizophrenic or schizoaffective disorders often occur in early adulthood and thus affect women of childbearing age. For paliperidone information about reproductive safety is wanting. Therefore, we evaluated data from the German Embryotox pharmacovigilance institute regarding paliperidone therapy during pregnancy. The German Embryotox pharmacovigilance institute offers risk assessment on drug use in pregnancy and documents the outcome of more than 3500 drug-exposed pregnancies per year. In our study, we analyze the outcome of all pregnancies with paliperidone exposure, which have been assessed by our institute between January 2007 and June 2016...
March 22, 2018: Archives of Women's Mental Health
Julia F Litzky, Maya A Deyssenroth, Todd M Everson, Barry M Lester, Luca Lambertini, Jia Chen, Carmen J Marsit
BackgroundDepression and/or anxiety during pregnancy have been associated with impaired fetal growth and neurodevelopment. Because placental imprinted genes play a central role in fetal development and respond to environmental stressors, we hypothesized that imprinted gene expression would be affected by prenatal depression and anxiety.MethodsPlacental gene expression was compared between mothers with prenatal depression and/or anxiety/obsessive compulsive disorder/panic and control mothers without psychiatric history (n=458) in the Rhode Island Child Health Study...
May 2018: Pediatric Research
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