Postpartum Depression: A Clinical Review of Impact and Current Treatment Solutions.

Autor: Dennis CL; Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada. cindylee.dennis@utoronto.ca.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Rm 280, Toronto, ON, M6J 1H4, Canada. cindylee.dennis@utoronto.ca.; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. cindylee.dennis@utoronto.ca., Singla DR; Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada.; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada., Brown HK; Department of Health and Society, University of Toronto, Toronto, Canada.; Women's College Hospital, Toronto, Canada.; Women's College Research Institute, Toronto, Canada., Savel K; Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada., Clark CT; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.; Women's College Hospital, Toronto, Canada.; Women's College Research Institute, Toronto, Canada., Grigoriadis S; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.; Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada., Vigod SN; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.; Women's College Hospital, Toronto, Canada.; Women's College Research Institute, Toronto, Canada.
Jazyk: angličtina
Zdroj: Drugs [Drugs] 2024 Jun; Vol. 84 (6), pp. 645-659. Date of Electronic Publication: 2024 May 30.
DOI: 10.1007/s40265-024-02038-z
Abstrakt: Depression during the first year postpartum (postpartum depression) impacts millions of women and their families worldwide. In this narrative review, we provide a summary of postpartum depression, examining the etiology and consequences, pharmacological and psychological treatments, and potential mechanisms of change and current barriers to care. Psychological treatments are effective and preferred by many perinatal patients over medications, but they often remain inaccessible. Key potential mechanisms underlying their effectiveness include treatment variables (e.g., dosage and therapeutic alliance) and patient behaviors (e.g., activation and avoidance and emotional regulation). Among pharmacological treatments, the selective serotonin reuptake inhibitor (SSRI) sertraline is generally the first-line antidepressant medication recommended to women in the postpartum period due to its minimal passage into breastmilk and the corresponding decades of safety data. Importantly, most antidepressant drugs are considered compatible with breastfeeding. Neurosteroids are emerging as an effective treatment for postpartum depression, although currently this treatment is not widely available. Barriers to widespread access to treatment include those that are systematic (e.g., lack of specialist providers), provider-driven (e.g., lack of flexibility in treatment delivery), and patient-driven (e.g., stigma and lack of time for treatment engagement). We propose virtual care, task-sharing to non-specialist treatment providers, and collaborative care models as potential solutions to enhance the reach and scalability of effective treatments to address the growing burden of postpartum depression worldwide and its negative impact on families and society.
(© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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