Zachary Stowe

..Pregnant women with psychiatric illness treated with zolpidem may have less optimal obstetrical outcome, though it is unclear if this was related to the medication...

..Inconsistent diagnostic criteria fail to delineate guidelines for postpartum depression surveillance. This study evaluates the validity of commonly accepted postpartum onset criteria...

..Familiarity with the extant literature and its limitations and practical considerations will enable optimizing treatment plans that maintain maternal mental health, minimize nursing infant exposures, and provide infant monitoring...

..CONCLUSION: These results extend previous studies by demonstrating the utility of breast milk analysis in interpreting infant serum concentrations and minimizing infant exposure...

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..Although the significance of amniotic fluid exposure remains to be determined, these results demonstrate that maternally administered antidepressants are accessible to the fetus in a manner not previously appreciated...

..The objectives of the current study were to quantify placental permeability to antipsychotic medications and to document obstetrical outcomes for women taking these agents proximate to delivery...

..This review summarizes the current data on drug transporters in the placental passage of medications, with a focus on medications used in clinical psychopharmacology...

..The high risk of bipolar depression during pregnancy encourages consideration of lamotrigine (LTG). We therefore compared recurrence risks among pregnant women with BPD treated with LTG to those discontinuing mood stabilizer therapies...

..We sought to characterize the determinants of lamotrigine concentrations in breast milk and nursing-infant plasma...

..The current study characterizes the level and determinants of venlafaxine and desvenlafaxine concentrations in breast milk and in nursing infant plasma...

..The majority of previous studies in this area focus on adult offspring, and the degree to which the effects of parental child abuse can be detected earlier in the development of the offspring remains obscure...

..Paralleling the preclinical literature are human studies indicating similar acute effects. The clinical implications for the psychiatric treatment of depressed women who have children will be discussed...

..This article reviews findings in preclinical research on the adverse impact of parental depression on the development of offspring, with emphasis on the relevance of this research for the psychiatric care of depressed parents...

..Infant exposure and limitations to monitoring infant sera are reviewed. Lastly, a model and guide for reducing fetal and infant exposures is presented...

..The method is shown to be a highly accurate and precise technique for measuring 12 different antidepressants in human breast milk and to be free of the matrix effects often encountered in breast milk drug analyses...

..CONCLUSIONS: The in vivo ratios of umbilical cord to maternal serum drug concentrations demonstrate considerable fetal exposure and differ greatly from previous results utilizing ex vivo perfusion...

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..In contrast, the amniotic fluid, umbilical cord, and nursing infant sera literature demonstrated significantly different exposures to individual medications...

..The potential roles of comorbid maternal anxiety disorders, timing of maternal depression, and maternal treatment with psychotropic medications during pregnancy are addressed...

..In conclusion, PPD rates are higher among women with epilepsy than the general population, particularly those who are multiparous or receiving AED polytherapy, and there is no evidence that AED selection modifies this risk...

..These basic guidelines can help decrease the number of exposures and aid in conducting clinical care with at least some reproductive safety data...

..The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population...

..Further studies are warranted to investigate the utility of venlafaxine in perimenopausal depression...

..Increased platelet activation may underlie the increased risk of coronary artery disease (CAD) in patients with MDD...

..These data suggest that PPD may be associated with unique alterations in serotonergic function that are specific to the puerperium...

..However, systematic delineation of risk of relapse in women who maintain or discontinue pharmacological treatment during pregnancy is necessary...

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..This study determined the placental transfer of antidepressants and their metabolites...

..Child abuse and trauma alter the endogenous stress response, principally corticotropin-releasing hormone and its downstream effectors, suggesting that a gene x environment interaction at this locus may be important in depression...

..Pregnancy has frequently been described as a time of emotional well-being conferring 'protection' against psychiatric disorders. However, data to support this impression are sparse...

..Cohen, Nonacs and Otto), the Women's Life Center and Mood Disorders Research Program at UCLA (Dr. AItshuler, Dr. Hendrick), and the Emory Women's Mental Health Program at Emory University School of Medicine (Dr. Stowe). ..

..The achievement of the objectives address several research priority areas noted in ORWH Agenda for Research on Women's Health for the 21st century. ..

..Delineating of these subgroups provides an opportunity to screen for women "at risk" for relapse and allows for thoughtful treatment plan. ..