admin's blog

Anti-TNF therapy during pregnancy

We've known for years that pregnant women that consume Anti-TNF antibodies such as etanercept and many other such drugs,  that the transfer of these monoclonal IgG molecules into the fetus is highest during the last trimester of pregnancy.  This new study suggests that most moms can stop the use of these drugs in the 30th week of gestation and reduce the exposure of the infant to these drugs and also reduce the moms relapse into Crohn's and Ulcerative colitis.  This of course depends on the mom's medical condition.

New Antidepressant for Postpartum Depression

A new and novel treatment for POSTPARTUM DEPRESSION has just been introduced and is indicated for severe refractory PPD.  Derived from the natural steroid hormone, allopregnanolone, this novel steroid acts directly in the brain to reduce depression.  Its only problem is that it requies a 60 hour IV infusion of drug in a clinical environment. Studies show it is highly effective.  Again, its indicated for SEVERE refractory PPD.

High Potency Cannabis Linked to higher risk of Psychosis

This study suggests that Daily use of HIGH potency cannabis may be associated with higher rates of pyschosis. Daily users of high potency cannabis were 5 times more likely to encounter Psychosis. 

(My take on this...) Cannabis has a high attraction for lipid rich adipose (fatty) tissue. Once filled with daily use of high levels of THC, plasma levels probably rise signficantly leading to super high levels of THC in the brain leading to Psychosis.

Long-term Risk of Neuropsychiatric Disease After Exposure to Infection In Utero.

Large study of 1 791 520 Swedish children suggests  fetal exposure to a maternal infection while hospitalized increased the risk for autism and depressionthat.

New Treatment for Postpartum Depression

A new IV drug was just released for the treatment of Postpartum Depression.  Called Brexanolon (Zulresso),  it requires a continuous infusion over 60 hours. 

Therapeutic strategies for treating epilepsy during pregnancy.

Excellent article that covers the use of anticonvulsants during pregnancy. As expected Valproic acid is the worst and should be avoided.  Folic Acid is greatly beneficial to the fetus.  Not much data on the newer anticonvulsants but many are safer. Good read.

Safety of atovaquone-proguanil during pregnancy.

While malaria during pregnancy dramatically increases fetal complications,  apparently the drugs might do so as well.  18.5% of exposed pregnancies resulted in miscarriage and 11.8% were elective terminations. 

Risk of Ocular Anomalies in Children Exposed in Utero to Antimalarials: A Systematic Literature Review.

This extensive review answered one of my long-time questions: Do the antimalarials cause ophthalmic damage when used in infancy?  This extensive reveiw suggests they don't and are apparently reasonably safe to use,  even in Breastfeeding mothers which we are asked about all the time.

Update - Lithium in the Long-Term Treatment of Bipolar Disorders

This article is interesting in that it suggests that Lithium therapy may be linked to reduced risk of Alzheimer's diseas and stroke.

Determination of Mesalamine levels in Human Milk as a Function of Dose.

This recently published study from my laboratories shows that levels of Mesalamine (5-Aminosalicylic acid) in human milk are exceedingly low. Despite the dose,  the relative infant doses in these 10 moms  (RID) were all lower than 0.1%.  Good news,  moms can safely use these products for ulcerative colitis and Crohn's disease.

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