You may not know it, but this year marks a milestone in the world of SSRI teratology research. Ten years ago, JAMA published the first controlled study of Prozac exposure in pregnancy (1). The results? Neither Prozac nor tricyclics caused more birth defects than controls, but both antidepressants caused more neonatal complications.

It’s not all about meds. This is especially true in treating postpartum depression, because so many women are understandably reluctant to expose their breast-feeding infants to antidepressants. This article reviews interpersonal therapy (IPT) as an effective modality for post-partum depression.

Dr. Hendrick, there has been a lot of confusing and seemingly contradictory data about the safety of SSRIs during pregnancy. What’s your take?

Roseann Gumina, M.D., is an obstetrician/gynecologist in private practice in Milwaukee, Wisconsin. Like most OB/GYNs, Dr. Gumina sees more pregnant women on antidepressants in a given year than most psychiatrists are likely to see in a lifetime, and her perspective is informative.

In 1956, a German company synthesized thalidomide (its brand name was “Contergan”) and launched it the next year in Europe as a sedative. Unlike sedatives available at the time, such as the barbiturates, thalidomide was apparently completely non-addictive and had few if any side effects.

There are now no fewer than 14 FDA-approved psychostimulants… and counting. This does not include the many generics, the new non-stimulant Straterra or the off-label ADHD meds Wellbutrin (bupropion) and desipramine.

The Eli Lilly reps are almost delirious about their new ADHD “miracle drug”, Straterra (atomoxetine). This is not surprising.

They have been flooding into your office: grown-ups who believe that they have ADHD.

Dr. Prince, you have done innumerable evaluations of children and adults with ADHD. These days, psychiatrists in the community are besieged by patients wanting treatment for ADHD, and the pressure is on to come up with a diagnosis and treatment during a single 45 minute session. Is this possible?

David Sorenson, M.D., is medical director of the Anna Jaques Hospital Child Psychiatry Inpatient Unit in Amesbury, Massachusetts. His experiences with patients misusing ADHD medications should give us pause.