Updated on Jun 30, 2022 | Featured, Mental Health, OB/GYN, Psychiatry, Research, Women's Health, Your Health
Approximately half of women who use antidepressants before pregnancy decide to discontinue use either before or during pregnancy due to concerns about the negative consequences for their child.
Those who are pregnant or who may be thinking of getting pregnant may wonder if taking antidepressants could affect the heath of the child. New research from Mount Sinai offers some potentially important findings and shows that the underlying mental health of the parents is more of a concern than the medication itself.
The study shows that while there is a link between maternal antidepressant use during pregnancy and affective disorders in the child later in life, the link also exists between paternal antidepressant use during pregnancy and child mental health.
The data suggest the observed link is most likely due to the underlying mental illness of the parents rather than any “intrauterine effect,” which means any effect the medication could have on the fetus developing inside the uterus. These affective disorders include depression and anxiety.
“Our study does not provide evidence for a causal relationship between in-utero exposure to antidepressants and affective disorders in the child,” says Anna-Sophie Rommel, PhD, an instructor in the Department of Psychiatry at Icahn Mount Sinai and first author of the paper. “So, while other long-term effects of intrauterine exposure to antidepressants remain to be investigated, our work supports antidepressant continuation for women who would like to continue taking their medication, for example because of severe symptoms or a high risk of relapse. It is important to note that untreated psychiatric illness during pregnancy can also have negative consequences on the health and development of the child. Women and their health care providers should carefully weigh all of the treatment options and jointly decide on the best course of action.”
Anna-Sophie Rommel, PhD
Approximately half of women who use antidepressants before pregnancy decide to discontinue use either before or during pregnancy due to concerns about the negative consequences for their child, according to Dr. Rommel, who is also an expert in epidemiology and has been studying how the COVID-19 pandemic disproportionately affects pregnant women in underserved communities.
Major depressive disorder is highly prevalent, with one in five people experiencing an episode at some point in their life, and is almost twice as common in women than in men. Antidepressants are usually given as a first-line treatment, including during pregnancy, either to prevent the recurrence of depression, or as acute treatment in newly depressed patients. Antidepressant use during pregnancy is widespread and since antidepressants cross the placenta and the blood-brain barrier, concern exists about potential long-term effects of intrauterine antidepressant exposure in the unborn child.
Using the Danish National Registers to follow more than 42,000 babies born during 1998-2011 for up to 18 years, researchers at the Icahn School of Medicine at Mount Sinai investigated whether exposure to antidepressants in the womb would increase the risk of developing affective disorder like depression and anxiety in the child.
In a study published April 5 in Neuropsychopharmacology, the scientists found that children whose mothers continued antidepressants during pregnancy had a higher risk of affective disorders than children whose mothers stopped taking antidepressants before pregnancy.
However, to understand whether the underlying disorder for which the antidepressant was given or the medication itself was linked to the child’s risk of developing an affective disorder, they also studied the effect of paternal antidepressant use during pregnancy and similarly, found that children of fathers who took antidepressants throughout pregnancy had a higher risk for affective disorders. Thus, the research team speculates that rather than being an intrauterine effect, the observed link is most likely due to the parental mental illness underlying the antidepressant use.
Updated on Jun 30, 2022 | Community, Featured, Psychiatry, Vaccines
From left: Raymond Rene, Office of Mental Health (OMH); Ruth Llanos, OMH Psychiatric Nurse; Paul Michael Avellaneda, OMH Psychiatric Nurse; Michelle Izmirly, DO; Gariy Livshits, OMH Treatment Team Leader
Earlier this year, the New York State Office of Mental Health (OMH) launched a program to bring vaccine doses to mental health patients, as many have trouble navigating the internet or don’t have smartphones and need help facilitating appointments. The OMH program was designed for patients to come to state psychiatric centers, but they were also eager to expand their reach and offered to set up vaccine pods at all OMH licensed clinics across the state. Michelle Izmirly, DO, Medical Director of Ambulatory Psychiatry at The Mount Sinai Hospital, reached out to OMH so that The Mount Sinai Hospital’s clinic could be included as a site.
“We see a very vulnerable patient population, and I knew a lot of our patients weren’t comfortable going to places like the Javits Center,” said Dr. Izmirly. “Some were even crying because they were so scared and so frustrated; often, they lacked internet access or cellular service to navigate the New York State vaccine eligibility website. We’re the ones they know. They know our setting and our staff, and they’re more comfortable getting the vaccine with us. They were so grateful that they had this option.”
It was a true team effort to pull it off. OMH scheduled a site visit to make sure the clinic had the appropriate setup: strong Wi-Fi, a comfortable area for injections, and supportive staff. Rajvee Vora, MD, Vice Chair of Clinical Affairs for the Department of Psychiatry, collaborated with Ania Wajnberg, MD, Medical Director of Ambulatory Care at The Mount Sinai Hospital and Site Lead for Vaccine Operations. They engaged the pharmacy and engineering departments to ensure the clinic had the appropriate equipment to safely store the vaccine.
Due to special efforts by Patricia Lamb, Chief of Ancillary and Support Services, Sue Mashni, PharmD, Chief Pharmacy Officer, and Michael Roche, PE, Senior Director of Engineering, the clinic space was converted to a safe and effective vaccine pod in one week. Eva Bayon, Administrative Manager, and Joan Bell, LCSW, Clinical Director of Ambulatory Psychiatry Services, handled the logistics of confirming and scheduling patients. Alicia Hurtado, MD, Associate Dean for Medical Student Wellness and Student Affairs, arranged for medical students to volunteer to monitor the patients for 15 minutes after they received the vaccination.
On April 8, the team vaccinated 72 patients—10 every 30 minutes starting at 9:30 am. And this might only be the beginning. The vaccine pod was such a success that OMH will return May 6 to reach the patients who were unable to attend their appointment that day. If OMH continues to provide the doses, the clinic could continue to offer it to their patients moving forward.
Cassidy Leverett, a care coordinator at the clinic, believes that the stability for these patients is key. “A lot of people find it really difficult to schedule the vaccine because it can be far from where they live or work, so it’s really great that people can go to a place they’re familiar with and see faces that they know. It’s been a very crazy time so it’s nice to have one stable place where you can go get your vaccine.”
Dr. Izmirly hopes this spreads beyond her clinic to other mental health clinics and practices. “You see so many news stories and research studies about people with mental illness contracting and dying from COVID-19 at higher rates than those who don’t suffer from mental illness,” she said. “We’ve even lost some of our own patients, which was completely devastating. This is an opportunity to help our own patients in our own settings, where we know they’ll feel comfortable.”
Mar 26, 2021 | Psychiatry
This year’s American Psychiatric Association conference takes place virtually May 1-3. The schedule of talks from Mount Sinai’s faculty is listed below.
Dr. Yehuda presenting at APA in 2019.
Sunday, May 2
Psychedelic-Assisted Psychotherapy for PTSD: Theory, Technique and Context
Presenter: Rachel Yehuda, PhD
Time: 4:00-5:30pm
Delivering HIV Prevention and Care to Transgender People: An Update
Presenters: Max Lichtenstein, MD, Kenneth Ashley, MD, and Carmen Cassanovas, MD
Time: 4:00-5:30pm
Monday, May 3
Friend, Frenemy, or Foe: The Role of Adolescent Social Media Use in Race Based Trauma
Presenter: Gabrielle Shapiro
Time: 11:30am-1:00pm
To Tweet or Not to Tweet: Social Media Use for Professional Development and for Mental Health Research
Presenter: Kara Bagot, MD
Time: 4:00-5:30pm
Mar 26, 2021 | Psychiatry
This year’s Society of Biological Psychiatry conference takes place virtually April 29-May 1. The schedule of talks from Mount Sinai’s faculty is listed below.
Thursday, April 29
Irritability Partly Accounts for the Association Between Pain and Depression: Findings From the EMBARC and STRIDE Studies and the VitalSign6 Project
Presenter: Manish Jha, MD
When: 5:15-5:30pm (Central Time)
Neurons from PTSD combat veterans (MAP2=magenta, GFAP=yellow, DNA=white). Image courtesy of Michael Breen, PhD.
Friday, April 30
Inflammation and PTSD From the Macro to Microscale
Presenter: Michael Breen, PhD
When: 4:30-6:30pm (Central Time)
Advancing Treatment of Substance Use Disorders Through Computational Modeling
Presenter: Xiaosi Gu, PhD
When: 4:30-6:30pm (Central Time)
Irritability and Aggression in Psychiatric Illnesses: Translational Approaches in Identifying Novel Mechanisms and Treatment Targets
Chair: Manish Jha, MD
Presenter: Scott Russo, PhD
When: 4:30-6:30pm (Central Time)
Maternal Psychiatric Diagnosis and Comorbidities Around Pregnancy
Presenter: Vahe Khachadourian, MD, PhD
When: 5:45-6:00pm (Central Time)
An image from Dr. Frangou’s presentation.
Saturday, May 1
That’s a Wrap: Identifying Myelin as a Treatment Target in Psychosis Across Multiple Scales of Resolution
Presenter: Sophia Frangou, MD, PhD
When: 1:30-3:30pm (Central Time)
Bipolar Disorder: New Biological Insight and Potential Clinical Relevance From Large-Scale Genetic Studies
Presenter: Niamh Mullins, PhD
When: 1:30-3:30pm (Central Time)
Getting Motivated in Stressful Times
Presenter: Ming Hu Han, PhD
When: 5:00-7:00pm (Central Time)
Nov 30, 2020 | Psychiatry
This year’s American College of Neuropsychopharmacology (ACNP) conference takes place virtually December 6-9. Faculty from the Department of Psychiatry will be contributing via the president’s plenary, panels, study groups, and posters. The schedule of talks is listed below.
Monday, Dec. 7
Loneliness and Social Isolation in the COVID-19 Era: New Directions for Neurobiology and Mental Health Research
Concurrent Panel and Study Group Sessions
When: 1:30-3:30pm
Participant: Dennis Charney, MD
Clinical High Risk (CHR) for Psychosis: Where Do We Go Next?
Concurrent Panel and Study Group Sessions
When: 1:30-3:30pm
Chair: Cheryl Corcoran, MD, MS
Participant: Yulia Landa, PsyD
Irritability: Translational and Transdiagnostic Approaches to Neural Circuitry, Development, and Treatment
When: 1:30-3:30pm
Presenter: Manish Jha, MD
Aggression: Gaps in our Knowledge and Strategies to Enhance Research in the Field
Concurrent Panel and Study Group Sessions
When: 5:30-7:30pm
Participants: Nelly Alia-Klein, PhD; M. Mercedes Perez-Rodriguez, MD, PhD
Tuesday, Dec. 8
Sensitive Postnatal Time Windows for Prefrontal Cortical Circuit Maturation
Concurrent Panel and Study Group Sessions
When: 8:30-10:30am
Presenter: Hirofumi Morishita, MD, PhD
Functional and Systems Genomic Approaches to Psychiatric Disorders
Concurrent Panel and Study Group Sessions
When: 8:30-10:30am
Chair: Kristen Brennand, PhD
Presenter: Laura Huckins, PhD
Mobile DNA in Brain Diseases
Concurrent Mini-Panel Sessions
When: 2:30-3:30pm
Presenter: Sandhya Chandrasekaran, BS
Insight Into Sex Differences in Psychiatric Syndromes From Transcriptomic and Genomic Analyses
Concurrent Panel and Study Group Sessions
When: 5:00-7:00pm
Chair: Eric Nestler, MD, PhD
Impact of the COVID-19 Pandemic on the Pipeline and Workforce of Physician-Scientists
Concurrent Panel and Study Group Sessions
When: 5:00-7:00pm
Chair: M. Mercedes Perez-Rodriguez, MD, PhD
Moderator: Antonia New, MD
Participant: René Kahn, MD, PhD
Wednesday, Dec. 9
Targeting Brain Circuits for Reward and Affect With Deep Brain Stimulation
Concurrent Panel and Study Group Sessions
When: 8:30-10:30am
Chair: Helen Mayberg, MD
Presenter: Martijn Figee, MD, PhD
Oct 30, 2020 | Psychiatry
Dr. Newman at a lecture in 1988. Image courtesy of the Levy Library’s Arthur H. Aufses, Jr., MD Archives and Records Management.
The Addiction Institute of Mount Sinai received an endowed gift from the Estate of Blanche Ross, facilitated by Trustee Bobbie Abrams, for an annual lecture series. The Dr. Robert Newman Lecture in Addiction aims to attract national academic leaders each year to discuss the most current research and trends in addiction. The lecture is hosted at Mount Sinai Beth Israel in memory of Dr. Newman’s passion to serve patients suffering with addiction.
Dr. Newman was an internationally recognized expert on addiction treatment and one of the early pioneers of viewing addiction as a chronic medical condition. As President and Chief Executive Officer of Beth Israel Medical Center from 1978 to 1997, Dr. Newman worked to expand access to addiction and psychiatric services, HIV and AIDS treatment, and care for the LGBT community. He also oversaw the creation of the Jacob Perlow Hospice, the first Jewish hospice in Manhattan.
As President of Continuum Health Partners from 1997 to 2000, Dr. Newman led the integration and merger of the hospitals now known as Mount Sinai Beth Israel, Mount Sinai Morningside, Mount Sinai West, and the New York Eye and Ear Infirmary of Mount Sinai. During that time, he effectively fended off efforts to limit opioid treatment program in the city.
Before joining Beth Israel, Dr. Newman served as Assistant Commissioner of Addiction for the New York City Department of Health, where he was the guiding force in creating and expanding what would become the largest network of methadone maintenance treatment programs in the country. Many of the programs are still in operation through Mount Sinai Beth Israel.
His reach extended beyond the United States as he strongly influenced the landscape of opioid treatment in Germany and Hong Kong. In fact, he was dubbed the “methadone apostle/pope” as he achieved a position of worldwide leadership.
Dr. Newman’s remarkable career was grounded in his commitment to public health and never-ending advocacy for underserved populations, which made a tremendous impact on the communities served by the Mount Sinai Health System. He was a passionate and formidable advocate who was driven to use science to propel his activism, stating: “There are times when researchers have a responsibility to involve themselves in the political process to try to directly influence policy implementation. In such instances, the familiar, perhaps more comfortable role of the scientist must be supplemented by political activism to avoid research becoming a rationale for withholding help and to ensure its appropriate role in influencing policy.”
