Advances in pharmacotherapy for postpartum depression: a structured review of standard-of-care antidepressants and novel neuroactive steroid antidepressants

Kaufman, Yardana; Carlini, Sara V.; Deligiannidis, Kristina M.

doi:10.1177/20451253211065859

Cited by 20 publications

(9 citation statements)

References 102 publications

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“…Diverse mediators of PPD that are involved in complex pathophysiological changes provide support for hormonal and non-hormonal pharmacological interventions. The current use of typical antidepressants to treat PPD suffers from limited evidence of safety and efficacy coupled with suboptimal outcomes ( 31 , 32 ). Psychotherapy or antidepressants was recommended by the American Psychiatric Association as first-line treatment for mild-to-moderate PPD ( 33 ).…”

Section: Pharmacological Approaches and Implicationsmentioning

confidence: 99%

Post-partum depression: From clinical understanding to preclinical assessments

Moreira

Custodio

et al. 2023

Front. Psychiatry

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Post-partum depression (PPD) with varying clinical manifestations affecting new parents remains underdiagnosed and poorly treated. This minireview revisits the pharmacotherapy, and relevant etiological basis, capable of advancing preclinical research frameworks. Maternal tasks accompanied by numerous behavioral readouts demand modeling different paradigms that reflect the complex and heterogenous nature of PPD. Hence, effective PPD-like characterization in animals towards the discovery of pharmacological intervention demands research that deepens our understanding of the roles of hormonal and non-hormonal components and mediators of this psychiatric disorder.

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Section: Pharmacological Approaches and Implicationsmentioning

confidence: 99%

Post-partum depression: From clinical understanding to preclinical assessments

Moreira

Custodio

et al. 2023

Front. Psychiatry

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“…53 Some individuals with moderate to severe PPD may receive treatment with brexanolone, a recently approved positive allosteric modulator of GABA type A receptors. 84 One small meta-analysis of RCTs suggest brexanolone IV infusion can rapidly reduce depressive, anxious, and insomnia symptoms in PPD. 85 In addition to being quite expensive, 86 common adverse events include sedation, loss of consciousness, dry mouth, and hot flushes.…”

Section: Moderate To Severe Perinatal Depressionmentioning

confidence: 99%

“…85 In addition to being quite expensive, 86 common adverse events include sedation, loss of consciousness, dry mouth, and hot flushes. 84 Contraindications includes a history of hypersensitivity reactions to neuroactive steroids and end-stage renal failure. 84 Although not a contraindication, other central nervous system depressants (eg, benzodiazepines) or other psychotropic medications with prosedative properties (eg, mirtazapine) should be avoided while receiving brexanolone as these medications may exacerbate its sedating effects.…”

Section: Moderate To Severe Perinatal Depressionmentioning

confidence: 99%

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Perinatal Depression: A Guide to Detection and Management in Primary Care

Dama,

Van Lieshout

2023

J Am Board Fam Med

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Introduction: Existing guidelines for primary care clinicians (PCCs) on the detection and management of perinatal depression (PD) contain important gaps. This review aims to provide PCCs with a summary of clinically relevant evidence in the field.Methods: A narrative literature review was conducted by searching PubMed and PsycINFO for articles published between 2010 to 2023. Guidelines, systematic reviews, clinical trials, and/or observational studies were all examined.Results: Screening with the Edinburgh Postnatal Depression Scale or Patient Health Questionnaire-9 followed by a diagnostic evaluation for major depressive disorder in probable cases can enhance PD detection. At-risk individuals and mild to moderate PD should be referred for cognitive behavioral therapy or interpersonal psychotherapy when available. Selective serotonin reuptake inhibitors should be used for moderate to severe PD, with sertraline, escitalopram, or citalopram being preferred first. Using paroxetine or clomipramine in pregnancy, and fluoxetine or doxepin during lactation is generally not preferred. Gestational antidepressant use is associated with a small increase in risk of reduced gestational age at birth, low birth weight, and lower APGAR scores, though whether these links are causal is unclear. Sertraline and paroxetine have the lowest rate of adverse events during lactation. Consequences of untreated PD can include maternal and offspring mortality, perinatal complications, poor maternal-infant attachment, child morbidity and maltreatment, less breastfeeding, and offspring developmental problems.Conclusions: These clinically relevant data can support the delivery of high-quality care by PCCs. Risks and benefits of PD treatments and the consequences of untreated PD should be discussed with patients to support informed decision making. ( J Am Board Fam Med 2023;00:000-000.

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“…Few data exist on the treatment of synthetic progesterone. 21 Psychological counselling, psychosocial interventions, physical therapy, kinesitherapies and Chinese medicine treatment are some of the current non-pharmacological treatments for PPD. 2 22 23 Several systematic reviews and meta-analyses (SRs/MAs) have been conducted on the efficacy of non-pharmacological therapy for PPD.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of non-pharmacological treatments for postpartum depression: an umbrella review protocol

Yang

Liu

et al. 2023

BMJ Open

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IntroductionNon-pharmacological treatments for postpartum depression have been investigated in various systematic reviews, and their efficacy has been evaluated. However, the quality of the evidence as a whole has not been quantified. The quality of this evidence may influence the choice of interventions and even cause misleading clinical decisions. This study aims to provide an objective presentation of the methodological bias and identify treatments supported by solid evidence.Methods and analysisFor the purpose of conducting systematic reviews and meta-analyses, a comprehensive search of the relevant published literature will be conducted in English databases such as PubMed, Embase, Cochrane Library, PsycINFO and Scopus, as well as in four Chinese databases: the Chinese Biomedical Databases (CBM), Wan fang database, China National Knowledge Infrastructure and VIP Database (VIP). The time of publication will be limited from their inception to 31 May 2022. We will extract the following data from the included literature: title, first author, journal type of included literature, number and sample size, intervention/control measures, outcome indicators and main study outcomes. The Assessment of Multiple Systematic Reviews-2 will be used to measure the quality of the methods. In addition, we will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to evaluate the quality of the reporting, as well as the Grading of Recommendations Assessment, Development and Evaluation to evaluate the quality of the evidence.PROSPERO registration numberCRD42021285470.

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Advances in pharmacotherapy for postpartum depression: a structured review of standard-of-care antidepressants and novel neuroactive steroid antidepressants

Cited by 20 publications

References 102 publications

Post-partum depression: From clinical understanding to preclinical assessments

Post-partum depression: From clinical understanding to preclinical assessments

Perinatal Depression: A Guide to Detection and Management in Primary Care

Effectiveness of non-pharmacological treatments for postpartum depression: an umbrella review protocol

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