Antidepressants for preventing postnatal depression

Molyneaux, Emma; Telesia, Laurence; Henshaw, Carol; Boath, Elizabeth; Bradley, Eleanor; Howard, Louise M.

doi:10.1002/14651858.cd004363.pub3

Cited by 53 publications

(54 citation statements)

References 33 publications

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“…[86][87][88][89]. A recent Cochrane review concluded that further studies with greater numbers of participants are necessary in order to make any conclusions about the effectiveness of antidepressants for the prevention of PPD [90].…”

Section: Prophylactic Treatmentmentioning

confidence: 99%

Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development

et al. 2019

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Postpartum depression is one of the most common complications of childbirth. Untreated postpartum depression can have substantial adverse effects on the well-being of the mother and child, negatively impacting child cognitive, behavioral, and emotional development with lasting consequences. There are a number of therapeutic interventions for postpartum depression including pharmacotherapy, psychotherapy, neuromodulation and hormonal therapy among others, most of which have been adapted from the treatment of major depressive disorder outside of the peripartum period. Current evidence of antidepressant treatment for postpartum depression is limited by the small number of randomized clinical trials, underpowered samples and lack of longterm follow-up. The peripartum period is characterized by rapid and significant physiological change in plasma levels of endocrine hormones, peptides and neuroactive steroids. Evidence supporting the role of neuroactive steroids and GABA in the pathophysiology of postpartum depression led to the investigation of synthetic neuroactive steroids and their analogs as potential treatment for postpartum depression. Brexanolone, a soluble, proprietary, intravenous preparation of synthetic allopregnanolone has been developed. A recent series of open-label and placebocontrolled randomized clinical trials of brexanolone in postpartum depression demonstrated rapid reduction of depressive symptoms, and have led to the submission for regulatory approval to the US Food and Drug Administration (decision due in March 2019). SAGE-217, an allopregnanolone analog, with oral bioavailability, was recently tested in a randomized, double-blind, placebocontrolled phase 3 study in severe postpartum depression, with reportedly positive results. Finally,

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Section: Prophylactic Treatmentmentioning

confidence: 99%

Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development

et al. 2019

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“…The studies which investigated antidepressants found that sertraline was more likely to exhibit preventative effects in developing postpartum depression and reduce the extent of depressive symptoms in the postpartum period. These studies found that sertraline was more effective in reducing the risk of developing postpartum depression and experiencing postpartum depressive symptoms compared to nortriptyline (Howard et al, 2005;Molyneaux et al, 2018;Pariser, Nasrallah, & Gardner, 1997). Other studies compared sertraline with a placebo in treating postpartum depression.…”

Section: Analysis Of Resultsmentioning

confidence: 99%

Considering Xenobiotics as Risk Factors for Postpartum Depression: A Qualitative Systematic Review

Mitchell¹,

Edali²,

Konkle³

2020

jhms

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“…International Publications. 20 As there is no absolute contraindication to taking antidepressant medications during pregnancy, they should not be stopped abruptly, which would increase the risk of depression relapse with a rebound effect. 21,22 In France in 2016, 5% of women were exposed to at least one anxiolytic-hypnotic drug during pregnancy.…”

Section: And the 2018 International Cochrane Reviewmentioning

confidence: 99%

Trajectories of antidepressant drugs during pregnancy: A cohort study from a community‐based sample

Cabaillot

Bourset

Mulliez

et al. 2020

Brit J Clinical Pharma

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The aim of this study was to monitor the trajectories of antidepressant use during pregnancy and the postpartum period among women chronically treated with antidepressants before their pregnancy, and to assess characteristics associated with each trajectory. Methods: This cohort study included all pregnant women whose data were included in the General Sample of Beneficiaries (EGB) database affiliated with the French Health Insurance System, from 2009 to 2014. Women were followed up until 6 months after childbirth. Chronic treatment was defined as exposure over the 6-month period preceding pregnancy. A group-based trajectory model (GBMT) was estimated to identify distinctive longitudinal profiles of antidepressant use. Results: Among 760 women chronically treated with antidepressants before their pregnancy, 55.8% stopped their treatment permanently in the first trimester, 20.4% discontinued it for a minimum of 3 months and resumed it postpartum, and 23.8% maintained it throughout pregnancy and postpartum. No sociodemographic or medical characteristics were associated with any trajectory group. Women who maintained treatment presented more frequent obstetric complications and postpartum psychiatric disorders. Among women who interrupted treatment, prescription of benzodiazepines and anxiolytics decreased initially but rose postpartum to a higher level than before pregnancy. Conclusions: Pregnant women treated with antidepressant require a re-evaluation of psychiatric treatment. It is necessary to pay attention to obstetric complications for severely depressed women. Additionally, as relapse was associated with increased benzodiazepine use, it is important to carefully monitor all women who stop antidepressant treatment during pregnancy.

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Antidepressants for preventing postnatal depression

Cited by 53 publications

References 33 publications

Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development

Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development

Considering Xenobiotics as Risk Factors for Postpartum Depression: A Qualitative Systematic Review

Trajectories of antidepressant drugs during pregnancy: A cohort study from a community‐based sample

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