Depression Drug Treatment Outcomes in Pregnancy and the Postpartum Period

McDonagh, Marian; Matthews, Annette M.; Phillipi, Carrie A.; Romm, Jillian; Peterson, Kimberly; Thakurta, Sujata; Guíse, Jeanne Marie

doi:10.1097/01.aoa.0000469461.45993.de

Cited by 17 publications

(25 citation statements)

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“…Given the questions about the effectiveness of SSRIs to treat postpartum affective disorders it is advantageous to consider non-pharmacological therapies [126,127]; such therapies include various forms of psychotherapy, parenting classes, dietary supplements, 'alternative' therapies and exercise [27,128,129]. It is also recommended that treatment for depression and anxiety during the postpartum period be individualized with treatment success often being evident after a combination of treatments (pharmacology, dietary, psychotherapy) [114].…”

Section: ) Non-pharmacologicalmentioning

confidence: 99%

The Neurobiology of Postpartum Anxiety and Depression

Pawluski¹,

Lonstein²,

Fleming³

2017

Trends in Neurosciences

235

169

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Ten to twenty percent of postpartum women experience anxiety or depressive disorders, which can have detrimental effects on the mother, child, and family. Little is known about the neural correlates of these affective disorders when they occur in mothers, but they do have unique neural profiles during the postpartum period compared with when they occur at other times in a woman's life. Given that the neural systems affected by postpartum anxiety and depression overlap and interact with the systems involved in maternal caregiving behaviors, mother-infant interactions are highly susceptible to disruption. Thus, there is an intricate interplay among maternal mental health, the mother-infant relationship, and the neurobiological mechanisms mediating them that needs to be the focus of future study.

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Section: ) Non-pharmacologicalmentioning

confidence: 99%

The Neurobiology of Postpartum Anxiety and Depression

Pawluski¹,

Lonstein²,

Fleming³

2017

Trends in Neurosciences

235

169

View full text Add to dashboard Cite

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“…Despite the availability of effective medications, many mothers prefer not to use psychotropic medications in the perinatal period because of the fear of adverse effects. 216 Discussions about the risks and benefits of using or withholding medications are important for parents to have with their own adult health care providers so they can make informed decisions regarding the role of antidepressant medications used antenatally or in the postpartum period, especially while breastfeeding. Studies about the long-term effects on the infant of maternal antidepressant medication use, such as SSRIs, during pregnancy are mixed, because it is difficult to control for many other cooccurring factors that may influence birth outcomes, including maternal illness or problematic health behaviors.…”

Section: Psychotherapy and Psychological Interventionsmentioning

confidence: 99%

“…Studies about the long-term effects on the infant of maternal antidepressant medication use, such as SSRIs, during pregnancy are mixed, because it is difficult to control for many other cooccurring factors that may influence birth outcomes, including maternal illness or problematic health behaviors. 216 In 1 study, mothers made a list of potential risks and benefits of treatment with medication in the context of their therapeutic goals for a healthy pregnancy and postpartum period. An exercise like this should be conducted in partnership with appropriate providers, including the parent's prescriber, who can provide accurate information.…”

Section: Psychotherapy and Psychological Interventionsmentioning

confidence: 99%

Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice

Mattson²,

et al. 2018

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Perinatal depression is the most common obstetric complication in the United States, with prevalence rates of 15% to 20% among new mothers. Untreated, it can adversly affect the well-being of children and families throught increasing the risk for costly complications during birth and lead to deterioration of core supports, including partner relationships and social networks. Perinatal depression contributes to long-lasting, and even permanent, consequences for the physical and mental health of parents and children, including poor family functioning, increased risk of child abuse and neglect, delayed infant development, perinatal obstetric complications, challenges with breastfeeding, and costly increases in health care use. Perinatal depression can interfere with early parent-infant interaction and attachment, leading to potentially long-term disturbances in the child's physical, emotional, cognitive, and social development. Fortunately, perinatal depression is identifiable and treatable. The US Preventive Services Task Force, Centers for Medicare and Medicaid Services, and many professional organizations recommend routine universal screening for perinatal depression in women to facilitate early evidence-based treatment and referrals, if necessary. Despite significant gains in screening rates from 2004 to 2013, a minority of pediatricians routinely screen for postpartum depression, and many mothers are still not identified or treated. Pediatric primary care clinicians, with a core mission of promoting child and family health, are in an ideal position to implement routine postpartum depression screens at several well-child visits throughout infancy and to provide mental health support through referrals and/or the interdisciplinary services of a pediatric patient-centered medical home model.

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“…Progesteronstudien liegen nur mit synthetischen Substanzen vor und haben die Symptomatik eher verschlechtert (26). Deswegen wegen sollte ein Therapieversuch mit Estradiol auch nicht mit Gestagenen kombiniert werden (26) (27)(28)(29)(30).…”

Section: S Krüger: Depression Bei Frauenunclassified

“…Das günstigste mütterliches Serum/kindliches Serum Verhältnis haben Sertralin und Paroxetin, mit nicht nachweisbaren Konzentrationen, gefolgt von Citalopram, Escitalopram und Bupropion. Höchste Konzentrationen finden sich bei Fluoxetin und Venlafaxin, während für Agomelatin und Du-loxetin keine Daten vorliegen (27)(28)(29)(30). Ob eine nachweisbare Konzentration eines Antidepressivums im kindlichen Körper auch automatisch adverse Reaktionen bedeutet, ist nicht hinreichend untersucht, zumal die mütterliche Erkrankung selbst beim Kind zu erheblichen Symptomen führen kann (Koliken, Schreianfälle, Unruhe, Trinkschwäche).…”

Section: S Krüger: Depression Bei Frauenunclassified

Depression bei Frauen

Krüger¹

2015

Nervenheilkunde

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ZusammenfassungFrauen leiden häufig im Zusammenhang mit reproduktiven Ereignissen, also vor der Menstruation, während und nach der Schwangerschaft und in den Wechseljahren an affektiven Erkrankungen. Dieses liegt an den komplexen Zusammenhängen zwischen weiblichen Geschlechtshormonen und Neurotransmittern, aber natürlich auch an den Einflüssen belastender oder sich verändernder Lebensumstände. Affektive Symptome können in diesen Zusammenhängen erstmals manifest werden, und in Symptomausprägung oder Schwere variieren. Wochenbetterkrankungen betreffen fast 20% aller Frauen und bergen das Risiko der Schädigung des Kindes durch Vernachlässigung, durch komorbide Zwangssymptome und im extremen Fall durch Infantizid. Die Ursachen der Wochenbettdepression, die sich meist sechs Wochen nach der Geburt manifestiert, sind nicht geklärt. Die Therapie umfasst psychopharmakologische und psychotherapeutische Interventionen, erstere in Abhängigkeit davon, ob die Patientin stillen kann oder möchte. Die Perimenopause ist im Leben einer Frau die Zeit mit dem höchsten Depressionsund Angsterkrankungsrisiko. Hier sind die Zusammenhänge zwischen hormonellen Veränderungen und der psychischen Symptomatik gut belegt. Behandlungsstrategien beinhalten demnach sowohl hormonelle als auch psychopharmakologische, in manchen Fällen auch psychotherapeutische Interventionen.

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Depression Drug Treatment Outcomes in Pregnancy and the Postpartum Period

Cited by 17 publications

References 0 publications

The Neurobiology of Postpartum Anxiety and Depression

The Neurobiology of Postpartum Anxiety and Depression

Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice

Depression bei Frauen

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