Antidepressant treatment for postnatal depression

Molyneaux, Emma; Howard, Louise M.; McGeown, Helen; Karia, Amar M.; Trevillion, Kylee

doi:10.1192/apt.20.6.368

Cited by 28 publications

(39 citation statements)

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“…69 Successful treatment of maternal depression may reduce these risks. 70 Breastfeeding is not contraindicated during treatment with an antidepressant medication. Concerns about breastfeeding during medication treatment include short-term adverse reactions and longer-term neurodevelopmental effects.…”

Section: How Is Depression Treated During the Postpartum Period?mentioning

confidence: 99%

“…Second-line treatments include citalopram, escitalopram, and sertraline, which have data for effectiveness during the postpartum period, minimize risk during lactation, and pose the least known risk during the childbearing years. 70 Structured exercise and depression-specific acupuncture are complementary and alternative treatments that have some evidence in the postpartum period. [71][72][73] An increasing body of evidence also supports the use of therapist-assisted Internet-based behavioural activation and CBT, whereas the effectiveness of unsupported Internet-based psychotherapeutic interventions has not been established.…”

Section: How Is Depression Treated During the Postpartum Period?mentioning

confidence: 99%

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Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

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Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section on ''Special Populations'' is the sixth of six guidelines articles.Results: Recent studies inform the treatment of MDD in children and adolescents, pregnant and breastfeeding women, women in perimenopause or menopause, and the elderly. Evidence for efficacy of treatments in these populations is more limited than for the general adult population, however, and risks of treatment in these groups are often poorly studied and reported. Conclusions: Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.

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Section: How Is Depression Treated During the Postpartum Period?mentioning

confidence: 99%

Section: How Is Depression Treated During the Postpartum Period?mentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

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“…Antidepressant medication is commonly used as a firstline treatment for postnatal depression, and selective serotonin reuptake inhibitors are likely to be effective 16 ; however, potential medication adverse effects are worrisome to both mothers and clinicians. 17 Transmission through breast milk is a concern.…”

Section: Management Of Postnatal Depressionmentioning

confidence: 99%

Effectiveness of Psychological Interventions for Postnatal Depression in Primary Care: A Meta-Analysis

Stephens

Ford

Paudyal

et al. 2016

The Annals of Family Medicine

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PURPOSE Postnatal depression affects 10% to 15% of new mothers, and approximately 90% of cases are managed in primary care. Antidepressants are effective, but adherence is poor; therefore, psychological interventions must be investigated. In this systematic review, we assessed the efficacy of psychological therapies for postnatal depression in primary care. METHODSWe undertook a systematic search to identify articles published in English between 2000 and 2014 that reported studies meeting our eligibility criteria:(1) had a randomized controlled trial design; (2) assessed psychological interventions for postnatal depression against any other treatment or a wait-list control; (3) recruited patients in primary care; and (4) enrolled mothers with a diagnosed depressive episode or a score of at least 12 on the Edinburgh Postnatal Depression Scale or at least 10 on the Beck Depression Inventory at baseline who had a child younger than 12 months. Quality was assessed using an adapted Cochrane Collaboration Depression, Anxiety, and Neurosis (CCDAN) quality rating scale, and meta-analysis was carried out using RevMan 5.3 (The Cochrane Collaboration).RESULTS Screening of 5,919 articles identified 10 studies that met inclusion criteria. These studies reported on 14 psychological intervention arms: 7 using cognitive behavioral therapy, 2 using interpersonal therapy, 2 using counseling, and 3 using other interventions. Psychological interventions resulted in lower depressive symptomatology than control both immediately after treatment (standardized mean difference = -0.38; 95% CI, -0.49 to -0.27) and at 6 months of follow-up (standardized mean difference =-0.21; 95% CI, -0.37 to -0.05). We did not find any significant differences between the various types of therapy. Compared with control, the interventions also led to improvements in adjustment to parenthood, marital relationship, social support, stress, and anxiety.CONCLUSIONS Psychological interventions deliverable in the primary care setting are associated with a significant improvement in depressive symptomatology both immediately after completion and for up to 6 months of follow-up. Ann Fam Med 2016;14:463-472. doi: 10.1370/afm.1967. INTRODUCTIONA bout 13% of mothers experience postnatal depression during the first year after delivery.1 If left untreated, this condition can have an extensive negative impact on women, children, and wider society. A recent report found that the annual cost to UK society of perinatal depression was £73,822 ($104,574) per case, of which 70% was due to adverse impacts on the child.2 Effects on the child can arise because of impaired maternal-infant bonding, maternal withdrawal, disengagement, hostility, and shortening of the duration of breastfeeding. [3][4][5][6][7][8][9][10][11][12] Other consequences of postnatal depression include marital difficulties and an increased risk of future depression, with affected mothers twice as likely to experience further episodes of depression in the subsequent 5 years. 13 Research has shown tha...

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“…In addition, it has not been confirmed that adding SSRI to the therapy significantly improved its effectiveness [46,47].…”

Section: Discussionmentioning

confidence: 99%

Stolen motherhood-case study of postpartum depression

Gerhant

Olajossy

Kalińska

et al. 2016

Current Problems of Psychiatry

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Aim: The objective was to analyze the case of postpartum depression complicated with extended suicide attempt.Method: The analysis of clinical case and medical history.Results: In 25-year-old patient, two weeks after childbirth, postpartum depression episode occurred. In the further course of illness psychotic symptoms (delusions, mood disorders), suicidal and infanticide thoughts emerged. Four weeks after childbirth, the patient killed her baby and took an unsuccessful suicidal attempt. Based on medical records, several risk factors of postpartum depression were identified: 1. obstetric and child-related risk factors: Caesarean section, premature birth, obstetric complications during pregnancy, infant’s difficult temper, difficulties related to breastfeeding; 2. psychological risk factors: baby blues, high anxiety level during pregnancy, high level of stress related to child care.Conclusions: Psychoeducation of women during pregnancy, including their families, is an extremely crucial element of postpartum depression prevention. It is also necessary to raise awareness among healthcare professionals who have frequent contact with mothers after childbirth: midwives, gynaecologists and paediatricians.

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Antidepressant treatment for postnatal depression

Cited by 28 publications

References 0 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

Effectiveness of Psychological Interventions for Postnatal Depression in Primary Care: A Meta-Analysis

Stolen motherhood-case study of postpartum depression

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