Of course, we all know that human beings are social creatures. Relationships with other people are critical to our mental and physical well-being. We share this quality with other species, notably with primates. A chimpanzee ostracized from the social group will fade away and die. Studies of newborns have revealed the ways that they interact with their parents, showing early capacity for relationship. Sounds like a good survival tactic, doesn’t it? A newborn’s survival is completely dependent on the willingness of adults to provide ongoing constant caretaking. Since this is a huge sacrifice for the parents, the baby’s ability to attract and sustain the attention of adults is crucial. Anyone who has ever taken a baby out in public has seen the remarkable social magnetism that an infant emits. Nearly every passer-by makes eye contact with the baby, often smilling and stopping to talk to the baby. A new study shows that even in the womb, we have the drive to be socially engaged with others. The study looked at the movements of twins in the uterus and found that they spent more time touching each other than they spent touching the walls of the uterus or themselves. Amazing what we learn as techology allows us to see what was invisible.
Archive for the ‘Pregnancy’ Category
We Are Indeed Social Creatures
Thursday, November 11th, 2010Anti-Depressants and Pregnancy: Results from 2009
Tuesday, January 5th, 2010Studies about the effects of anti-depressants in pregnancy were numerous in 2009. The risk of preeclampsia (gestational hypertension) was elevated to 15.2% in women continuing SSRI medications after the first trimester, compared to 2.4% in women not on the meds. Women who stopped the SSRIs early in pregnancy had only 3.7% risk of preeclampsia, showing that it is not just the effect of the underlying condition i.e., depression.
Risk of cardiac septal defects was increased from 0.5% to 0.9% in babies whose mothers took SSRIs. These heart defects are considered minor, at least as compared to major cardiac defects.
There are conflicting reports about whether the meds cause pre-term birth or whether it is due to the underlying depression.
It is a sobering body of knowledge for me as a prescribing psychiatrist. Prescribing or continuing to prescribe meds during a patient’s pregnancy is a very serious decision. The woman and her partner have to be educated and encouraged to consider all the factors and risks. I am relieved that the pregnant patients I have prescribed meds for have all had normal deliveries and healthy babies.
Anti-depressants and pregnancy
Monday, May 11th, 2009The March 2009 issue of the American Journal of Psychiatry contains an article describing new risks associated with the use of some anti-depressants in pregnancy. Women taking SSRI’s in late pregancy had higher rate of hypertension and preeclampsia than women not taking these medications. The SSRI’s (serotonin reuptake inhibitors) are the most commonly prescribed group of anti-depressants and include Prozac, Zoloft, Paxil, Lexapro, and Celexa. These results make the decisions surrounding treating depression in pregnancy even more difficult. I would like to see a study done to determine the outcomes of depressed pregnant women treated with psychotherapy rather than medication. Some interesting data is out there that indicates that elderly people with anxiety do just as well with psychotherapy as they do with meds. This was a helpful study because using medication in the elderly comes with a elevated risk profile, just like using meds in pregnancy is more complicated.
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