Depression in pregnancy

The risks of untreated depression in pregnancy should be considered. These included low birth weight, maternal suicidality, potential for hospitalization or marital discord, poor prenatal care, and difficulty caring for other children. 

Gotlib, I.H., Whiffen, V.E., Mount, J.H., Milne, K., and Cordy, N.I. (1989) Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. / Consult Clin Psychol. 57 269-274. 

Intense interest in the potential for SSRI antidepressants to have teratogenic and adverse pregnancy outcomes continues, and four further major data-based reports have appeared [19, 20P, 21, 22 ], as well as a report on the management of depression in pregnancy from two leading US professiorml bodies [23 ] and three leading editorials or commentaries [24 , 25 , 26 ]. 

The term pasaon flower is used to denote many of the approximately 400 species of the herb. F saon flower has been used in medicine to treat pain, anxiety, and insomnia. Some herbalists use the herb to treat symptoms of parkinsonism. F saon flower is often used in combination with other herbs , such a valerian, chamomile, and hops, for promoting relaxation, rest and sleep. Although no adverse reactions have been reported, large doses may cause CNS depression. The use of passion flower is contraindicated in pregnancy and in patientstaking the monoamine oxidase inhibitors (MAOIs). Fission flower contains coumarin, and the risk of bleeding may be increased when used in patientstaking warfarin and pasaon flower. 

Briggs G, Freeman R, Yaffe S Drugs in Pregnancy and Lactation A Reference Guide to Maternal and Fetal Risk. Philadelphia, Lippincott, Williams Wilkins, 2002 Chengappa KN, Kambhampati R, Perkins K, et al Bupropion sustained release as a smoking cessation treatment in remitted depressed patients maintained on neatment with selective serotonin reuptake inhibitor antidepressants. J Clin Psychiatry 62 503—508, 2001... 

Anyone taking diuretics for longer than six months may experience a folate, or folic acid, deficiency. Folic acid plays a part in the health and reproduction of virtually every cell in the body. It is responsible for protein metabolism, the prevention of neural tube defects in pregnancy, blood cell production, and the synthesis of neurotransmitters. Individuals with folate deficiencies may suffer from anemia, depression and other mood disorders, and may give birth to babies with neural tube defects. Supplementation with folic acid may be useful in reversing these effects. 

Typical side effects are constitutional in nature, including a flu-like syndrome within 6 hours after dosing in more than 30% of patients that tends to resolve upon continued administration. Other potential adverse effects include thrombocytopenia, granulocytopenia, elevation in serum aminotransferase levels, induction of autoantibodies, nausea, fatigue, headache, arthralgias, rash, alopecia, anorexia, hypotension, and edema. Severe neuropsychiatric side effects may occur. Absolute contraindications to therapy are psychosis, severe depression, neutropenia, thrombocytopenia, symptomatic heart disease, decompensated cirrhosis, uncontrolled seizures, and a history of organ transplantation (other than liver). Alfa interferons are abortifacient in primates and should not be administered in pregnancy. 

In clinical practice, depressive symptoms were common in patients with physical illness, including cardiovascular disease, diabetes mellitus, end-stage renal disease, and women in pregnancy, following delivery or menopause. However, data that specifically addressed serum lipid profiles in patients with depressive disorders and physical illnesses were still scarce. 

Toxicity. Thalidomide has a low acute toxicity in 2 cases of reported overdose there was no evidence of respiratory or cardiac depression. Thalidomide has teratogenic effects when administered to women early in pregnancy. 

It was also observed (W6) that at termination of normal pregnancy, vitamin Be values were significantly depressed in maternal leucocytes and plasma. In blood of women in the last trimester of pregnancy, however, normal average amounts of the vitamin were found, although these individuals had a distinct abnormality in tryptophan metabolism. Amounts of pyridoxal phosphate are high in cord blood. 

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