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Medication Management of Major Depressive Disorder During Pregnancy and Lactation

Tuesday, September 10th 2019
7:00 PM EDT

Presenter: Tal Weinberger MD

60 minutes

Learning Objectives:
  1. To study the course of major depressive disorder during pregnancy and the postpartum period.
  2. To examine the impact of medication discontinuation and untreated mental illness on mother and baby
  3. To evaluate the risks and benefits of commonly used antidepressants and mood stabilizers during pregnancy and lactation
Agenda:

This lecture will be a review of the current psychiatric literature on the topic of the treatment of mood disorders during pregnancy and lactation. The objective of the lecture is to enable clinicians to support and educate their clients on these issues, and to help debunk common misconceptions about treatment during pregnancy and the postpartum period.

Resources for further study:
Anderson PO, Pochop SL, and Manoguerra AS. Adverse Drug Reactions in Breastfed Infants: Less than
Imagined. Clinical Pediatrics 2003; 42:325-340
Berle JO and Spigset O. Antidepressant Use During Breastfeeding. Current Women’s Health Reviews
2011. 7:28-34
Burt VK, Suri R, Altshuler L et al. The Use of Psychotropic Medications During Breastfeeding. Am J
Psychiatry 2001; 158: 1001-1009
Chad L, Pupco A, Bozzo P, Koren G. Update on antidepressant use during breastfeeding. Canadian Family
Physician 2013. 59: 633-634
Feldman R, Granat A, Pariente C, et al. Maternal Depression and Anxiety Across the Postpartum Year
and Infant Social Engagment, Fear Regulation, and Stress Reactivity. J Am Acad Child Adolesc.
Psychiatry 2009; 48 (9): 919-927.
Fihrer I, McMahon CA, Taylor AJ. The impact of postnatal and concurrent maternal depression on child
behavior during the early school years. Journal of Affective Disorders 2009; 119: 116-123
Gaillard A, Le Strat Y, Mandelbrot L et al. Predictors of postpartum depression: prospective study of 264
women followed during pregnancy and postpartum. Psychiatry research 2014; 215 (2): 341-6
Grace SL, Evindar A, and Stewart DE. The effect of postpartum depression on child cognitive
development and behavior: A review and critical analysis of the literature. Arch Women’s Mental
Health 2003; 6: 263- 274.
Hantsoo L, Ward-O’Brien D, Czarkowski KA. A Randomized, Placebo-Controlled, Double-Blind Trial of
Sertraline for Postpartum Depression. Psychopharmacology 2014; 231 (5): 939-948.
Katon W, Russo J, Gavin A. Predictors of Postpartum Depression. Journal of Women’s Health 2014; 23
(9); 753-759
Kimmel M, Hess E, Roy PS. Family history, not lack of medication use, is associated with the
development of postpartum depression in a high-risk sample. Arch Womens Ment Health 2015; 18:
113-121.
Ohoka H, Koide T, Goto S et al . Effects of maternal depressive symptomatology during pregnancy and
the postpartum period on infant-mother attachment. Psychiatry and Clinical Neurosciences 2014;
68:631- 639.
Raisanen S, Lehto SM, et al. Risk factors for perinatal outcomes of major depression during pregnancy: a
population-based analysis during 2002-2010 in Finland. BMJ Open 2014; 4(11):e004883.
Santucci AK, Singer LT, et al. Impact of prenatal exposure to serotonin reuptake inhibitors or maternal
major depressive disorder on infant developmental outcomes. J of Clinicial Psychiatry 2014; 75(10):
1088-95.
Sokol LE, Epperson CN, Barber JP. Preventing postpartum depression: A meta-analytic review. Clin
Psychol Rev. 2013; 33(8): 1205-1217
Suri R, Lin AS, et al. Acute and long-term behavioral outcomes of infants and children exposed in utero
to either maternal depression or antidepressants; a review of the literature. J Clinical Psychiatry 2014;
75(10): e1142-52.
Viguera AC, Tondo L, Koukopoulos AE, Episodes of Mood Disorders in 2,252 Pregnancies and Postpartum Periods. Am J Psychiatry 2011

This webinar offers 1 NYS ED Contact Hour

This lecture will examine the course of major depressive disorder during pregnancy and the postpartum period. It will evaluate the risks associated with medication discontinuation and untreated mood episodes, as reflected in the current psychiatric literature. It will evaluate the risks and benefits of commonly used antidepressants during pregnancy and lactation. A case presentations that illustrates these principles will be presented.

Learning Objectives:
  1. To study the course of major depressive disorder during pregnancy and the postpartum period.
  2. To examine the impact of medication discontinuation and untreated mental illness on mother and baby
  3. To evaluate the risks and benefits of commonly used antidepressants and mood stabilizers during pregnancy and lactation
Agenda:

This lecture will be a review of the current psychiatric literature on the topic of the treatment of mood disorders during pregnancy and lactation. The objective of the lecture is to enable clinicians to support and educate their clients on these issues, and to help debunk common misconceptions about treatment during pregnancy and the postpartum period.

Resources for further study:
Anderson PO, Pochop SL, and Manoguerra AS. Adverse Drug Reactions in Breastfed Infants: Less than
Imagined. Clinical Pediatrics 2003; 42:325-340
Berle JO and Spigset O. Antidepressant Use During Breastfeeding. Current Women’s Health Reviews
2011. 7:28-34
Burt VK, Suri R, Altshuler L et al. The Use of Psychotropic Medications During Breastfeeding. Am J
Psychiatry 2001; 158: 1001-1009
Chad L, Pupco A, Bozzo P, Koren G. Update on antidepressant use during breastfeeding. Canadian Family
Physician 2013. 59: 633-634
Feldman R, Granat A, Pariente C, et al. Maternal Depression and Anxiety Across the Postpartum Year
and Infant Social Engagment, Fear Regulation, and Stress Reactivity. J Am Acad Child Adolesc.
Psychiatry 2009; 48 (9): 919-927.
Fihrer I, McMahon CA, Taylor AJ. The impact of postnatal and concurrent maternal depression on child
behavior during the early school years. Journal of Affective Disorders 2009; 119: 116-123
Gaillard A, Le Strat Y, Mandelbrot L et al. Predictors of postpartum depression: prospective study of 264
women followed during pregnancy and postpartum. Psychiatry research 2014; 215 (2): 341-6
Grace SL, Evindar A, and Stewart DE. The effect of postpartum depression on child cognitive
development and behavior: A review and critical analysis of the literature. Arch Women’s Mental
Health 2003; 6: 263- 274.
Hantsoo L, Ward-O’Brien D, Czarkowski KA. A Randomized, Placebo-Controlled, Double-Blind Trial of
Sertraline for Postpartum Depression. Psychopharmacology 2014; 231 (5): 939-948.
Katon W, Russo J, Gavin A. Predictors of Postpartum Depression. Journal of Women’s Health 2014; 23
(9); 753-759
Kimmel M, Hess E, Roy PS. Family history, not lack of medication use, is associated with the
development of postpartum depression in a high-risk sample. Arch Womens Ment Health 2015; 18:
113-121.
Ohoka H, Koide T, Goto S et al . Effects of maternal depressive symptomatology during pregnancy and
the postpartum period on infant-mother attachment. Psychiatry and Clinical Neurosciences 2014;
68:631- 639.
Raisanen S, Lehto SM, et al. Risk factors for perinatal outcomes of major depression during pregnancy: a
population-based analysis during 2002-2010 in Finland. BMJ Open 2014; 4(11):e004883.
Santucci AK, Singer LT, et al. Impact of prenatal exposure to serotonin reuptake inhibitors or maternal
major depressive disorder on infant developmental outcomes. J of Clinicial Psychiatry 2014; 75(10):
1088-95.
Sokol LE, Epperson CN, Barber JP. Preventing postpartum depression: A meta-analytic review. Clin
Psychol Rev. 2013; 33(8): 1205-1217
Suri R, Lin AS, et al. Acute and long-term behavioral outcomes of infants and children exposed in utero
to either maternal depression or antidepressants; a review of the literature. J Clinical Psychiatry 2014;
75(10): e1142-52.
Viguera AC, Tondo L, Koukopoulos AE, Episodes of Mood Disorders in 2,252 Pregnancies and Postpartum Periods. Am J Psychiatry 2011

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