Therapy of peripartum mental disorders

Abstract

S U M M A R YDuring the peripartum period, women are at a greater risk of developing a mental disorder or experiencing an exacerbation of the pre-existing mental disorders. Therapeutic interventions are based primarily on psychotherapy, but if the symptoms are severe and pose a risk to the mother and the child, then the use of drugs, hospitalization or electroconvulsive therapy is considered. Cognitive-behavioral psychotherapy is the first line of treatment in postpartum blues and postpartum depression, panic disorder, generalized anxiety disorder, and mild to moderate obsessive-compulsive disorder. More recent conceptions regarding the use of drugs during the postpartum period indicate that medications should be prescribed if the risk of using them is lower than the risk of complications caused by the symptoms of mental disorders. Nortriptyline or desipramine are recommended from the group of tricyclic antidepressants, but newer generation antidepressants are shown to be safer during pregnancy. Fluvoxamine, paroxetine and sertraline can be used in postpartum period during breastfeeding, while fluoxetine and citalopram should be avoided. The use of first-generation antipsychotics haloperidol and trifluoperazine is recommended in the antepartum period, during which some of second-generation antipsychotics such as quetiapine, olanzapine, risperidone and aripiprazole can also be used. Clozapine should be avoided during breast-feeding. The use of mood stabilizers during pregnancy requires a thorough knowledge of the recommendations, and it is not advised to use them during the postpartum if the patient is breastfeeding. From the group of benzodiazepines, it is recommended to uselorazepam. Every form of therapeutic approach has proven to be more effective in the presence of emotional support from partners and other family members.

Experiences of women with psychological suffering in the puerperium: interpretations and meanings

“…It should be noted that maternal exhaustion related to newborn awakenings and sleep deprivation in uenced the onset of baby blues [70]. To avoid and/or mitigate this, there is a need to strengthen the supportive bonds, restore sleep and rest, and provide psychotherapeutic treatment using a cognitivebehavioural approach [70]. No relationship was observed between the number of children, ethnicity, women's education, and puerperal depressive symptoms [71].…”

Blackthorn—A Valuable Source of Phenolic Antioxidants with Potential Health Benefits

“…As a result, blackthorn extract showed a significant glucosidase inhibitory activity (129.46 ± 0.73). Furthermore, compared to standard anti-diabetic drugs (acarbose), blackthorn extract had a higher IC50 value [34,83].…”

“…Additionally, it was shown in this study that blackthorn oil presents a total concentration of mono and polyunsaturated fatty acids of 80.74% [32]. Because they have a high content of beta-sitosterol, vanillin, and gamma-tocopherols, cold press oils may have various applicability in food, health, and pharmaceutical industries [33,34]. The blackthorn extracts are also suitable for cosmetic use because of their photoprotective effects [35].…”