This week’s roundup features a slight variation on our weekly roundup. Rather than having to plow through a long list of articles, they are now separated into categories. We are all inundated with information these days; hopefully this will help to streamline your approach to what is now a burgeoning subspecialty.
Of note, the new treatment for postpartum depression — brexanolone, to be marketed as Zulresso by Sage Therapeutics — is due out this month. It has been reviewed by the DEA. According to the press release, Sage Therapeutics is planning to release Zulresso in late June and “continues to focus on identifying and activating Centers of Excellence (COE) and other healthcare settings capable of administering ZULRESSO to women with PPD.”
Zulresso was approved with a Risk Evaluation and Mitigation Strategy (REMS) and “will only be available to patients through a restricted distribution program at certified health care facilities where the health care provider can carefully monitor the patient.” We have not yet received any information on which sites will be offering treatment with Zulresso, but we will keep you posted.
Ruta Nonacs, MD PhD
PSYCHIATRIC ILLNESS DURING PREGNANCY
Jairaj C, Fitzsimons CM, McAuliffe FM, O’Leary N, Joyce N, McCarthy A, Cassidy E, Donnelly J, Tully E, Imcha M, Austin J, Doolin K, Farrell C, O’Keane V. Arch Womens Ment Health. 2019 Jun;22(3):349-355.
Overall, 15.8% of pregnant women scored >?12 in the EPDS. There was a significant association between gestational week and rates of depression, with increasing rates occurring with advancing pregnancy (p <?0.001).
Saxbe D, Mendez AJ. Biol Psychol. 2019 Jun 11:107718.
Ekrami F, Mohammad-Alizadeh Charandabi S, Babapour Kheiroddin J, Mirghafourvand M.
Community Ment Health J. 2019 Jun 10.
MEDICATIONS AND PREGNANCY
In Utero Exposure to Citalopram Mitigates Maternal Stress Effects on Fetal Brain Development.
Velasquez JC, Zhao Q, Chan Y, Galindo LCM, Simasotchi C, Wu D, Hou Z, Herod SM, Oberlander TF, Gil S, Fournier T, Burd I, Andrews AM, Bonnin A. ACS Chem Neurosci. 2019 Jun 11.
A study carried out in mice suggests that maternal stress and SSRI exposure in utero differentially impact serotonin-dependent fetal neurodevelopment such that exposure to the SSRI citalopram reverses key effects of maternal gestational stress on offspring brain development.
Selective serotonin reuptake inhibitor effects on neural biomarkers of perinatal depression.
Pawluski JL, Brain U, Hammond GL, Oberlander TF. Arch Womens Ment Health. 2019 Jun;22(3):431-435. Free Article
SSRIs significantly increase BDNF levels in late pregnancy and that S100B, but not BDNF, is associated with maternal depression in SSRI-treated women only. This shows that serum S100B could be a unique biomarker to determine efficacy of SSRIs during gestation.
POSTPARTUM PSYCHIATRIC ILLNESS
Premji S, McDonald SW, Metcalfe A, Faris P, Quan H, Tough S, McNeil DA.
Prev Med Rep. 2019 May 3. Free Article
Women screened as being high risk for PPD had an increased likelihood of diagnosis, higher PPD-related utilization and drugs dispensed compared to those women who were unscreened.
Efficacy of rTMS in decreasing postnatal depression symptoms: A systematic review.
Ganho-Ávila A, Poleszczyk A, Mohamed MMA, Osório A. Psychiatry Res. 2019 Jun 10.
rTMS shows promising results, with clinically significant decreases in Edinburgh Postnatal Depression Scale (EPDS) scores at week 4 and an overall low risk of dropout.
Yang R, Vigod SN, Hensel JM. J Med Internet Res. 2019 May 20. Free Article
Mental health literacy of maternal and paternal postnatal (postpartum) depression in British adults.
Swami V, Barron D, Smith L, Furnham A. J Ment Health. 2019 May 9:1-8.
Teshigawara T, Mouri A, Kubo H, Nakamura Y, Shiino T, Okada T, Morikawa M, Nabeshima T, Ozaki N, Yamamoto Y, Saito K. J Affect Disord. 2019 May 17;255:168-176.
MEDICATIONS AND BREASTFEEDING
Antidepressants in breast milk; comparative analysis of excretion ratios.
Schoretsanitis G, Augustin M, Saßmannshausen H, Franz C, Gründer G, Paulzen M. Arch Womens Ment Health. 2019 Jun;22(3):383-390.
MENOPAUSE AND MENTAL HEALTH
The prevalence of depression in menopausal women in China: A meta-analysis of observational studies.
Zeng LN, Yang Y, Feng Y, Cui X, Wang R, Hall BJ, Ungvari GS, Chen L, Xiang YT. J Affect Disord. 2019 Jun 5;256:337-343.
The pooled prevalence of depression in menopausal Chinese women was 36.3% (95% CI: 27.5-45.1%),
OTHER TOPICS IN WOMEN’S MENTAL HEALTH
Ralph LJ, Schwarz EB, Grossman D, Foster DG. Ann Intern Med. 2019 Jun 11.
During 5 years’ follow-up, women who had been denied abortions were more likely to report headaches, chronic joint pain, and poor overall health than women who had abortions.
McManus S, Gunnell D, Cooper C, Bebbington PE, Howard LM, Brugha T, Jenkins R, Hassiotis A, Weich S, Appleby L. Lancet Psychiatry. 2019 Jun 4. Free Article
Rates of nonsuicidal self-harm are rising, especially among adolescent girls and young adult women in England. Few of these people receive medical or psychological help,