Pharmacotherapy of postpartum depression

Abstract

Background: The prevalence and recurrence rates of postpartum depression (PPD) are 13 and 25%, respectively. Despite its detrimental impact on the health of the mother–infant dyad, there is a paucity of data in the literature regarding the efficacy of pharmacological treatment of PPD. Objectives: i) To review the literature on the use of antidepressants and hormonal supplements for the prevention and the treatment of PPD; ii) to give the authors' opinion on the current status of the pharmacological treatment of PPD; and iii) to discuss developments that are likely to be important in the future. Methods: An electronic search was performed by using PubMed, Medline, and PsychINFO. Inclusion criteria were: i) empirical articles in peer-reviewed English-language journals; ii) well-validated measures of depression; and iii) a uniform scoring system for depression among the sample. Results/conclusion: The electronic search yielded a total of 19 articles (12 on treatment and 7 on prevention of PPD) with the following study designs: eight randomized clinical trials (six using placebo control and two using active control groups), and 11 open-label studies. The selection of the specific antidepressant for a woman with PPD should derive from a personalized risk–benefit analysis.

Keywords::

• pharmacotherapy
• postpartum depression
• prevention
• treatment