Postpartum Progress

Effects of Medication on Infants at Delivery

The following study provides helpful information about the use of antidepressant medication during pregnancy and its effects on infants after delivery.  I find the results of this study comforting -- not that I think any ill effects on babies are a good thing -- since the possible withdrawal symptoms are so short-lived and don't have any long-term effect.

MONDAY, Feb. 6 (HealthDay News) -- Pregnant women who take selective serotonin reuptake inhibitor (SSRI) antidepressants such as Celexa, Paxil, Prozac and Zoloft could boost the risk of withdrawal symptoms for their newborns, a new study suggests.  However, the Israeli researchers add that these symptoms are usually gone within 48 hours and appear to pose no long-term threat to the infant's health.

Another expert noted that stopping antidepressant therapy during pregnancy poses its own risk to the health of a mother and her child.  "At present, probably the effect of not treating the women's clinical depression is a much bigger issue for mothers and their infants," said Dr. Tim Oberlander, an associate professor of pediatrics at the University of British Columbia and a developmental pediatrician at Children's & Women's Health Centre of British Columbia, Vancouver, Canada.

In the study, published in the February issue of the Archives of Pediatrics & Adolescent Medicine, a team at the Schneider Children's Medical Center of Israel studied the health of 120 newborns. Sixty of these babies' mothers took an SSRI to treat depression during their pregnancy, while the other 60 mothers did not.

The researchers assessed each infant's behavior two hours after birth and again at regular intervals to see if they displayed withdrawal symptoms.

Among the 60 infants exposed to SSRIs in the womb, 18 displayed what experts call "neonatal abstinence syndrome." In a minority of cases, this syndrome "may be severe enough to cause seizures," said senior researcher Dr. Gil Klinger, a neonatologist at the hospital. Of the 18 cases noted, eight were severe. The most common symptoms were tremors, gastrointestinal problems, an abnormal increase in muscle tone, sleep disturbances and high-pitched cries.

However, Klinger added that "signs of neonatal abstinence subside usually within a few days," he added, noting that none of the babies required treatment.

Based on the findings, Klinger advises that "infants born to mothers treated with SSRIs must be observed for a minimum period of 48 hours or longer if signs of a neonatal abstinence syndrome are evident."

Both mothers and their doctors should become aware of the possible effects of SSRIs on newborns, Klinger said. However, he said the findings don't mean women shouldn't take the drugs to ease depressive symptoms.  "It must be made clear that depression during pregnancy entails risk to the mother and her fetus, thus we are not suggesting cessation of medication," Klinger said ...

Oberlander agreed that women who need them should not stop taking their SSRIs during pregnancy.  "These findings are consistent with what others have found," he said ...

In his own research, Oberlander found that a mom's emotional state seems to be the biggest predictor of her child's long-term behavior. "It's the mother's mood that seems to have the greatest long-term effect, not prenatal exposure to SSRIs."

Tags: depression antidepressants pregnancy effects on infants

Genes and Depression

Here's some news I saw on msn.com today about women and depression.  Note especially the part I highlighted:

FRIDAY, Jan. 13 (HealthDay News) -- Women are more likely than men to inherit major depression from their parents, a U.S. study finds.

Researchers analyzed data from about 42,000 twins, and found that heritability of depression is 42 percent in women and about 29 percent in men. The study shows that genes contribute more strongly to the risk of depression in women, and that certain genetic factors may operate in one sex and not the other.

For example, there may be genes that alter the risk for depression in a woman's response to sex hormone cycles, particularly after childbirth. While these genes would affect a woman's risk for major depression, they wouldn't be a factor in men ...

"In particular, we have shown that depression is a moderately heritable disorder, suggesting that genetic factors are important, but by no means overwhelming," Kendler said.

The study appears in the January issue of the American Journal of Psychiatry.

Tags: postpartum depression research

Survivor Photo Album

One thing I've noticed on the talk show coverage of postpartum mood disorders is that they always only show sobbing, desperate mothers.  I, of course, have been a sobbing, desperate mother, but now I am a smiling, confident and joyous mother!  They never show the people who have recovered and are doing just fine -- perhaps it just doesn't make good television.   That frustrates me, because it doesn't show all of the women who are watching that there is a light at the end of the tunnel. 

To that end, I've decided to create a little photo album on Postpartum Progress of survivors of postpartum depression, postpartum OCD and postpartum psychosis. 

If you'd like to be in the photo album, please email me a photo (jpeg would be the best format) using the following guidelines:

1)  The photo needs to be of you with your child or children, since the subject of the album is happiness, survival and motherhood.

2)  Include basic information in the email: For your name you can use first name only (Katherine) or first name and last initial (Katherine S.).  For your location, just list your state (Georgia).   For your illness, just tell me what you survived (PPD, PPOCD or PPP) and what year (2001).  I don't want to put too much information in there since this is the Internet after all.

This album will serve to remind those of us who have been through it and those who are going through it that it is possible not only to survive but to THRIVE.

Tags: postpartum depression postpartum psychosis post partum depression postpartum OCD

Infertility Treatments and PPD

A week or so ago someone asked me whether there were any proven links between infertility treatments and postpartum mood disorders.  Today I found this article from last August (how did I miss this?), about some research on the subject:

In the the journal Fertility and Sterility, researchers in Australia reported that treatment for infertility appeared to be linked to an increased risk for developing emotional problems related to parenting. 

"Conceiving a child after undergoing infertility treatment was four times more likely to result in emotional issues related to parenting than having a child without such treatments ...

The Australian study included just over 700 new moms with mild to moderate depression, anxiety, or other emotional problems that led them to seek treatment at a special clinic.

The researchers determined that 6 percent of the mothers seeking emotional treatment conceived through infertility treatments. This is four times greater than the 1.5 percent of infants conceived through infertility treatments in the general population.

Mothers who conceived through IVF and other forms of assisted reproduction were more likely than other moms to be older, have multiple births, and have difficult deliveries that ended in cesarean sections -- three other suspected risk factors for postpartum depression.

The researchers suggest that women who achieve successful pregnancies after undergoing infertility treatment may benefit from additional emotional support before and after their babies are born."

As you may remember, Brooke Shields went through IVF and experienced postpartum depression, and I've talked to several other women who had the same experience.  We should make sure that women going through IVF speak with their doctors prior to birth about how to recognize the symptoms of postpartum mood disorders and the type of treatments that are available.

Tags: postpartum depression infertility IVF PPD research

Washington State Legislation on PPD

Yesterday I heard from Christin Jamieson, Communications Director for the Washington Council for the Prevention of Child Abuse and Neglect.  She informed me that Washington State passed legislation last year that will create a statewide postpartum depression awareness campaign.  (HOORAY!!!!)  They are planning to launch in March and are currently working on developing a new website that will be at www.speakup.wa.gov.   They're going to put my list of support groups from Washington on the site, and also link to Postpartum Progress, which I really appreciate.

Keep a look out for it and I'll keep you updated.

Tags: postpartum depression legislation washington

St. Louis and Miami added to PPD Support Group List

Download ppd_support_groups.doc

After my post yesterday, I heard about two MORE support groups -- one in Florida and one in Missouri.  This is GREAT.  I'm so glad to hear from people about the increasing opportunities for women to get together and help one another through this illness.  So please find above yet another revised list. 

We now have 15 of 50 states represented.  I just know there are more out there, so keep them coming.  And please let me know if a support group is closed down so that I can take it off the list.  I really want this list to be accurate at all times, so that a sufferer doesn't receive a glimmer of hope when seeing the list only to have those hopes dashed when they find out there isn't a group in their area anymore.

Tags: postpartum depression support groups PPD St. Louis Miami

Updated Support Group List

Attached is an updated PPD support group list -- I've added a group for Florence, SC, and one for Vorhees, NJ.  Download ppd_support_groups.doc

Tags: postpartum depression support groups New Jersey South Carolina

Help Rachel Walk for Suicide Prevention

I heard from Rachel, who is going to be participating in The Out of Darkness Overnight in San Francisco, put on by the American Foundation for Suicide Prevention (AFSP).  She will be walking this 20-mile journey through the night to raise awareness and support for postpartum depression.  She needs our help.

The AFSP describes the Out of the Darkness Overnight as a unique opportunity to help shed light on suicide, its impact and its prevention. They're bringing together friends, family members and loved ones whose lives have been touched by suicide or depression, and giving them a way to turn their heartbreak into hope for tomorrow. The Overnight will take place in San Francisco on July 22-23, and in Chicago on August 12-13.

Each walker agrees to raise at least $1,000. Net proceeds will benefit the American Foundation for Suicide Prevention, to fund research, education, survivor and awareness programs - both to prevent suicide and to assist those affected by suicide.  This is a link to Rachel's fundraising page.  Let's help her out if we can. 

Tags: postpartum depression postpartum psychosis suicide prevention perinatal depression

Andrea Yates released from jail on bail - Crime & Punishment - MSNBC.com

Andrea is finally getting to go where she should have been all along, at least for a while anyway. Link: Andrea Yates released from jail on bail - Crime & Punishment - MSNBC.com.

Study busts pregnant and happy myth

I got this news from CNN.com yesterday: Study busts pregnant and happy myth. I give it to you here, now, verbatim:

CHICAGO, Illinois (AP) -- Pregnant women who stop taking antidepressants run a high risk of slipping back into depression, a study found, busting the myth that the surge of hormones during pregnancy keeps mothers-to-be happy and glowing.

The study offers new information but no clear answers for expectant mothers who must balance the risk of medications harming the fetus against the danger of untreated depression.

"It's important that patients not assume that the hormones of pregnancy are going to protect them from the types of problems they've had with mood previously," said study co-author Dr. Lee Cohen of Massachusetts General Hospital.

The study does not deal with postpartum depression -- the depression that sets in after delivery, and is often blamed on hormonal changes. The research looks only at depression during pregnancy, a condition far less understood.

No one knows how many pregnant women are on antidepressants, but it is safe to say millions of women of childbearing age take them. Medco Health Solutions estimates 8.4 million American women ages 20 to 44 take antidepressants.

Other research has shown risks to the fetus, including possible heart defects, from antidepressant use during pregnancy.

Researchers followed 201 pregnant women with histories of major depression who were taking drugs such as Prozac, Zoloft, Effexor and Paxil.

Because of ethical concerns, the researchers did not randomly assign the women to either stop or continue medication. Instead, the women decided what to do, then researchers watched what happened.

Sixty-eight percent of those who stopped taking antidepressants slipped into depression. They were five times more likely to suffer a relapse than the women who continued on drugs.

But staying on antidepressants did not shield expectant mothers from depression entirely; 26 percent of those who continued drug treatment became depressed anyway.

Dr. Katherine Wisner of the University of Pittsburgh School of Medicine said the study makes an important contribution by quantifying the risk of relapse. She was not involved in the study but does similar work.

"I was taught in my residency that women don't get depressed during pregnancy," said Wisner, who was a psychiatry resident in the early 1980s. But "I had patients who were depressed. I asked my supervisor, 'You mean I'm really not seeing patients who are depressed?"'

The study appears in Wednesday's Journal of the American Medical Association and was funded by the National Institute of Mental Health. Two of the co-authors declared in the paper that they have financial ties to several antidepressant manufacturers.

Other researchers have shown that antidepressant use during the last three months of pregnancy can make newborns jittery and irritable, and sometimes can cause them serious breathing problems. In addition, the Food and Drug Administration has warned that Paxil may be linked to fetal heart defects when taken during the first three months of pregnancy.

Dr. Peter Kramer, author of "Listening to Prozac" and "Against Depression," said the study provides information that can help women and doctors decide what to do.

"Ideally, everyone would like to go through pregnancy off all medication," Kramer said. "But these are serious issues, and both decisions can be justified."

Kramer suggested some women might want to get off antidepressants but schedule more psychotherapy while pregnant.

Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Tag: postpartum depression, PPD research