Ep. 17 - Debunking Myths about Perinatal Psychiatric Medications with Dr. Niya Dhand, MD

For Maternal Mental Health Month, we knew we wanted to have a discussion on medications in the perinatal period. Because as much as AAPI folks can be reluctant to do therapy, they can also be just as wary about taking medications. But sometimes medications can play an important role in recovery, just like therapy can. So we wanted to talk with an expert on the psychiatric medications used during the perinatal period to dispel myths and empower our community to learn and ask about medications with their providers.

Joining us on today's episode is Dr. Niya Dhand, MD--a double fellowship-trained, double board-certified reproductive psychiatrist. Dr. Dhand went to medical school at Ohio State University and went on to complete her psychiatry residency at Cleveland Clinic. Then she did an addiction Psychiatry fellowship at Yale, where she focused specifically on treatment of addiction in women.

After a tragic second trimester pregnancy loss followed by a painful battle with infertility, Dr. Dhand went back and completed a Perinatal and Reproductive Psychiatry fellowship at Northwestern University, where she received in depth education and clinical experience in treating psychiatric conditions during pre-menses, infertility and loss, pregnancy, postpartum and perimenopause.

In this episode, Dr. Dhand helps us clarify information on safety of medications like SSRI (selective serotonin reuptake inhibitor) antidepressant/antianxiety medications in breastfeeding, during pregnancy, and in postpartum. We talk about the risk of untreated illness versus the risk that medications could bring. People often don't realize that untreated illness also carries a risk of harm to the fetus. For example, there is a small risk of miscarriage with untreated depression, but that risk is not present when you are taking an SSRI antidepressant.

Dr. Dhand also talks about the two real main concerns of SSRIs during pregnancy--neonatal adaptation syndrome and persistent pulmonary hypertension of the newborn. She breaks down what these things mean and what the real risk actually is in numbers. (Spoiler: it's pretty small!)

We talk about how and when someone might consider starting medications, whether or not SSRIs are "addicting," if Zoloft is really "the best choice" of antidepressants to start for pregnant and postpartum women. Dr. Dhand gives us a few examples of alternative therapy that have been proven to show some benefit and she gives us some resources she recommends moms can use over Google.

This episode goes in depth about the data, risks, and benefits of the most common psychiatric medications we think of during the perinatal period, but it by no means covers everything. Much of this information is shared transparently not to scare, but hopefully having some knowledge of what is truly important to look out for will empower our moms in their discussions with a provider to find a good fit if medications are in the picture.

Resources mentioned:

• Mother to Baby: https://mothertobaby.org/
• LactMed: https://www.ncbi.nlm.nih.gov/books/NBK501922/

Find Dr. Niya Dhand at:

• Instagram: www.instagram.com/drniyadhand
• PSI Provider Directory Listing: https://psidirectory.com/listing/dr-niya-dhand-meridian-psychiatric.html
• Dr. Dhand's Practice at Meridian Psychiatric Partners: https://meridianpsychiatricpartners.com/providers/

Note: The views, thoughts, and opinions expressed are the speakers' own.