Due to their inhibition of both serotonin and norepinephrine reuptake, the SNRIs venlafaxine (Effexor) and duloxetine (Cymbalta) have been billed as possessing an advantage over SSRIs.

The last time TCPR covered the topic of psychotropics in pregnancy was less than two years ago, in February of 2009. Since then, however, some new treatment guidelines have been published, and they appear to be useful to clinicians.

These new guidelines were issued jointly by our APA and by the American College of Obstetricians and Gynecologists. In addition to providing a nice summary of the neonatal risks of antidepressant exposure, the paper offers clear, concise, and easy to follow algorithms for the management of depression in three scenarios doctors are likely to encounter.

The Motherisk Program is a teratogen information service that has been around for more than 20 years.

SSRIs theoretically work by inhibiting the reuptake of serotonin, presumably by blocking the serotonin transporter pump whose job is to clean up excess serotonin in the synapses between neurons.

As we reviewed in the July/August 2009 issue of TCPR (Vol 7, Issue 7), cardiac disease leads to major depression, and, conversely, depression is a risk factor for developing cardiac disease.

SAMe, long a favorite of Italian psychiatrists, has hopped the pond and installed itself as a “natural” remedy for depression in the U.S.

Historically, research into the effectiveness of antidepressants for depressed youths has been unimpressive. The history of SSRI use in children has been fraught with its own series of disappointments and controversies.

The extent to which antidepressants are effective for pediatric depression continues to stir controversy, as discussed in this issue of CCPR.

No clinician wants to be a “pill-pusher,” and most of our patients do not want that kind of treatment. So what can we offer our depressed patients beyond medications?