Perinatal Flashcards
What effect does estrogen have on NT
Also levels during pregnancy
Increases SR and NE
Blocks DA (like an antipsychotic)
—-
T1 P>E
T3 reverse
When do you have high progesterone
Luteal phase of period
T2 and T3 of pregnancy
Tx for PMDD
OCP with drosperinone as the progesterone
(Yaz aka Loryna generic)
Fluox,sertealine, paroxitine
Last resort gnrh agonist
Non pharma treatments of PMDD
Aerobic exercise
Stress reduction cbt
Low salt and low caffeine diet
CAM for PMDD
Calcium carbonate 1200 mg daily
Vitamin b6 50-100 mg daily
Chaste berry 20 mg x6 days prior to menstruation
Perimenopausal depression has more symptoms of?
Higher cognitive symptoms
Irritability
Sleep disturbance
Disease evolution in bipolar and depression in women
Pregnancy high risk (40-50% have thymus episode
First year post partum high risk
Perimenooausal high risk bipolar (depressive ep)
Menopausal high risk bipolar (depressive so)
Perimenopausal high risk MDE
Post menopause NO RISK MDE
Who is most at risk in peripartum period (between bipolar and schizophrenia)
First year post partum?
Bipolar!
Bipolar!
No increased prevalence of bipolar or schizophrenia disorder in pregnancy!!
If affective symptoms, higher risk of exacerbation of schizophrenia in peripartum
Risk factors doe suicide in peripartum with depression
Adolescent moms
Psychiatric hospitalization
Peripartum depressive symptoms
More anxiety
(Preoccupied about health of baby, intrusive thoughts about hurting baby)
Guilt shame
Peaks 1st 3 months post
10-20% prevalence !!!!
Postpartum psychosis
Within 72 hours
Agitation, psychotic symptoms, confusion
HIGH SUICIDE AND INFANTICIDE 2/1000 and 4%
10-20% of bipolar moms will get it
Gold standard for PREVENTION is to treat with Li on PP day 1 (or antipsychotic)
Postpartum psychosis risk factors
Bb girl
Primipara
Amongst the usual
