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Pharmacotherapy for Perinatal Depression

Lusskin, Shari I; Khan, Sabrina J; Ernst, Carrie; Habib, Sally; Fersh, Madeleine E; Albertini, Elizabeth S
Perinatal depression is associated with serious risks for the mother, baby, and family. When considering treating perinatal depression with a drug indicated for the treatment of depression, the major concerns are whether the drug increases the risks of teratogenicity, pregnancy complications, poor neonatal adaptation, or neurodevelopmental disorders. Although different studies have produced different results, the majority have not shown increases in risk for selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, or the noradrenergic/dopaminergic drug bupropion. In this review we will discuss the reproductive safety data for these medications as well as monoamine oxidase inhibitors and benzodiazepines.
PMID: 29561284
ISSN: 1532-5520
CID: 3001472

Bipolar Disorder in Pregnancy and Postpartum: Principles of Management

Khan, Sabrina J; Fersh, Madeleine E; Ernst, Carrie; Klipstein, Kim; Albertini, Elizabeth Streicker; Lusskin, Shari I
Pregnancy and postpartum represent times of increased vulnerability for women with bipolar disorder, yet this condition remains under-diagnosed and under-treated. As 50 % of pregnancies are unplanned, the risks associated with the illness and the potential risks associated with treatment should be considered when a woman of reproductive age first presents for evaluation. This article reviews the epidemiology of perinatal bipolar disorder, screening recommendations, and treatment with pharmacotherapy and electroconvulsive therapy (ECT). An overview of the data in pregnancy and lactation is presented for lithium, lamotrigine, valproic acid, newer antipsychotics, and ECT. General principles of management include close monitoring in pregnancy and postpartum, careful adjustment of the treatment regimen to attenuate the risk of relapse, and avoidance of valproic acid when possible. Thoughtful consideration of these issues will minimize the risks to the mother and baby.
PMID: 26781551
ISSN: 1535-1645
CID: 1921382

Update on Depression in Pregnancy

Khan, Sabrina J; Lusskin, Shari I
ISSN: 0888-2398
CID: 141504