1/3. Can critically timed sleep deprivation be useful in pregnancy and postpartum depressions?BACKGROUND: The aim of this study was to test the efficacy of critically timed sleep deprivation in major mood disorders (MMD) occurring during pregnancy and postpartum. methods: Nine women who met DSM-IV criteria for a MMD with onset during pregnancy or within 1 year postpartum underwent a trial of either early-night sleep deprivation (ESD), in which they were sleep deprived in the early part of one night and slept from 03:00-07:00 h, or late-night sleep deprivation (LSD), in which they were deprived of sleep in the latter part of one night and slept from 21:00-01:00 h. Mood was assessed before the night of sleep deprivation, after the night of sleep deprivation, and after a night of recovery sleep (sleep 22:30-06:30 h) by trained clinicians, blind to treatment condition, using standardized scales. RESULTS: More patients responded to LSD (nine of 11 trials: 82%) compared with ESD (two of six trials: 33%) and they responded more after a night of recovery sleep (nine of 11 nights: 82%) than after a night of sleep deprivation (six of 11 nights: 55%). pregnant women were the only responders to ESD and the only nonresponders to LSD. LIMITATIONS: The small and heterogeneous sample size prevents us from making more definitive conclusions based on statistical analyses. CONCLUSIONS: Although the findings are preliminary, the results suggest that with further study, critically timed sleep deprivation interventions may benefit women with pregnancy or postpartum major mood disorders and potentially provide a viable alternative treatment modality for those women who are not candidates for pharmacologic or psychotherapeutic interventions. Such interventions are needed to help prevent the devastating effects of depression during pregnancy and the postpartum period on the mother, infant, her family and society.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/3. St. John's wort (hypericum perforatum)--is it safe during breastfeeding?Both doctors and patients often treat postnatal depression with herbal preparations derived from St. John's wort. Because these preparations are available to patients as "natural" over-the-counter drugs for depression, they are popularly assumed to be safe. However, no systematic information exists regarding treatment of postnatal depression, infant's safety or pharmacokinetics of hypericum constituents in human breast milk or infant plasma. A mother with post-natal depression was admitted at our service. Her pharmacist had recommended taking a St. John's wort preparation three times a day (Jarsin 300, Lichtwer Pharma AG, berlin, germany). Four breast-milk samples (fore and hind milk) during an 18-hour period were analyzed to measure concentration of hypericin and hyperforin. Only hyperforin is excreted into breast milk at a low level, hyperforin and hypericin (two major active components) were below the lower limit of quantification (BLQ: below lower limit of quantification, LQ hypericin: 0.20 ng/ml, LQ hyperforin: 0.50 ng/ml) in this infant's plasma. No side effects were seen in the mother or infant. Before recommending St John's wort for the treatment of depression to women who breastfeed, long-term studies of outcome in infants are needed.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
3/3. serum bupropion levels in 2 breastfeeding mother-infant pairs.BACKGROUND: These are the first reported data on bupropion and hydroxybupropion levels in infants whose treated mothers were breastfeeding. The information will assist physicians and parents in the risk-benefit decision-making process for bupropion treatment during breastfeeding. METHOD: serum samples were obtained by venipuncture from 2 mother-infant pairs. The serum was assayed for levels of bupropion and its most active metabolite, hydroxybupropion. RESULTS: Neither infant had quantifiable serum levels of bupropion or its metabolite at steady state. Neither infant had medical problems during the time of maternal therapy. CONCLUSION: We recommend obtaining and publishing additional serum level findings for breastfeeding mother-infant pairs since data for bupropion are favorable but limited.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |