In this article, I would like to talk about antidepressant treatment for postpartum depression.
Postpartum depression can occur within a year after a woman gives birth to a baby, but it affects not only the woman herself, but also the baby and her family.
There are several ways to deal with it, and you can choose one of them, but one of them is medication with antidepressants.
Depending on how you look at it, there are many ways to think about it, such as trusting in medication alone or combining it with other therapies because medication alone is not reliable.However, when it comes to medication, there are concerns about the effects on the baby since breastfeeding is involved.
There was a review of research on medication for such postpartum depression, and I would like to introduce it here.
Contents of the study
In May 2020, we searched for studies on antidepressants for women with postpartum depression and looked for randomized controlled trials in which participants were randomly treated.
The search results led to a review of 11 studies involving 1,016 women.
The studies compared antidepressants with placebo (dummy pills), usual care (follow-up, regular visits by care coordinators), psychological interventions, psychosocial interventions (peer support or counseling), other medications or other drugs.
Eight of the studies were conducted in English-speaking, high-income countries.
The duration of treatment ranged from 4 to 24 weeks.
How well did the treatments work? What is the effectiveness? was the focus of the search, and was measured by the number of people who responded well to the treatment and no longer met criteria for depression at the end of the treatment.
They also looked at whether women and their babies were adversely affected by the treatment.Women treated with antidepressants responded slightly better and had less severe postpartum depression than those who received a placebo.
Adverse effects were similar between groups, and there were no adequate studies comparing antidepressants with other types of treatment.
In these studies, the most studied antidepressants were from groups that used "SSRIs" (serotonin-specific reuptake inhibitors).
Reviewer's Conclusion
Evidence on the efficacy and safety of antidepressants in the management of postpartum depression is limited, especially for patients with more severe depression. As measured by response and remission rates, we found low certainty evidence that SSRI antidepressants may be more effective than placebo in treating postpartum depression. However, the low certainty of the evidence suggests that further research is very likely to have an important impact on the estimates of effectiveness. There is an ongoing urgency to better understand whether antidepressants or other treatments are more effective against postpartum depression, and for whom, and whether some antidepressants are more effective or better tolerated than others.
In clinical practice, the results of this review need to be contextualized by the extensive and growing literature on antidepressants and perinatal clinical guidance in the general population to inform individual risk-benefit clinical decisions. Future RCTs should focus on larger samples, longer follow-up, comparisons with alternative treatments, and inclusion of child and parenting outcomes.
Brown JV, Wilson CA, Ayre K, Robertson L, South E, Molyneaux E, Trevillion K, Howard LM, Khalifeh H. Antidepressant treatment for postnatal depression. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD013560. DOI: 10.1002/14651858.CD013560.pub2.
Conclusion
Although the results of the treatment used seemed to be promising compared to the control group, the adverse effects of concern are still unknown, which makes the choice a difficult one.
If I had to choose, I would probably choose counseling or other treatment methods over medication.
The reason for this is that I want to prioritize the improvement of my condition, but if I am breastfeeding, I am worried about the effect on my baby.
For those who have finished breastfeeding or are not breastfeeding, this method may be an option as well, but you can decide as long as you are comfortable with it.
