Virtual reality exposure therapy is effective for treating social fears, and improvement is maintained for 1 year. Virtual reality exposure therapy is equally effective as exposure group therapy; further research with a larger sample is needed, however, to better control and statistically test differences between the treatments.

All four antipsychotics demonstrated incomplete placental passage. Quetiapine demonstrated the lowest placental passage of the medications studied. These novel data provide an initial quantification of the placental passage of antipsychotics and fetal exposure in humans, demonstrating significant differences between individual medications.

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OBJECTIVE-Although lamotrigine use during pregnancy has substantially increased over the past decade secondary to accumulated reproductive safety data, systematic data on lamotrigine during breastfeeding remains sparse. We sought to characterize the determinants of lamotrigine concentrations in breast milk and nursing-infant plasma.PATIENTS AND METHODS-Women who enrolled in a prospective investigation of perinatal medication pharmacokinetics, were treated with lamotrigine, and chose to continue lamotrigine while breastfeeding were included in the analysis. Breast milk samples were collected via breast Address correspondence to D. Jeffrey Newport, MD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1365 Clifton Rd NE, Suite B6100, Atlanta, GA 30322. jeff.newport@emory.edu. Financial Disclosure: Dr Newport has received research support from Eli Lilly, GlaxoSmithKline, Janssen, Wyeth, the National Alliance for Research on Schizophrenia and Depression, and the National Institutes of Health and speaker's honoraria from AstraZeneca, Eli Lilly, GlaxoSmithKline, and Pfizer; Dr Pennell has received research support from GlaxoSmithKline, the National Institutes of Health, Marinus Pharmaceuticals, and UCB Pharma, has served on advisory boards for GlaxoSmithKline and UCB Pharma, and received speaker's honoraria from GlaxoSmithKline and UCB Pharma; Ms Calamaras has received National Institutes of Health research support; Dr Ritchie has received research support from GlaxoSmithKline and has served on advisory boards for CeNeRx Pharma and Abaxis; Ms Newman has received research support from GlaxoSmithKline, the National Institutes of Health, Marinus Pharmaceuticals, and UCB Pharma; Ms Knight has received research support from Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest, Janssen, the National Institutes of Health, Novartis, and Wyeth; Dr Viguera has received research support from the National Institutes of Health, the National Alliance for Research on Schizophrenia and Depression, a Harvard Medical School Scholars in Medicine Fellowship Award (Claflin Award), the Stanley Medical Research Institute, Astra-Zeneca, Berlex Laboratories, Eli Lilly, Forest, Pfizer, GlaxoSmithKline, Janssen, Novartis, Pfizer, Sepracor, and Wyeth, has served on advisory boards to GlaxoSmithKline, Novartis, and Wyeth, and received speakers' honoraria from Astra-Zeneca, Eli Lilly, GlaxoSmithKline, Novartis, and Wyeth; Dr Liporace receives research support from the National Institutes of Health and is on the speaker's bureau and advisory board for UCB Pharma and GlaxoSmithKline but does not receive financial compensation for these services; and Dr Stowe has received research support from GlaxoSmithKline, the National Institutes of Health, and Wyeth, served on advisory boards for Wyeth, Bristol-Myers Squibb, and GlaxoSmithKline, and received speakers' honoraria from Eli Lilly, GlaxoSmithKline, Pfizer, and Wyeth. pump from foremilk to hindmilk from a single breast to determine the excretion gradient and...

Discontinuing mood stabilizer treatment presents high risks of illness-recurrence among pregnant women diagnosed with BPD. LTG may afford protective effects in pregnancy, and its reported fetal safety compares favorably to other agents used to manage BPD.