Treating depression in pregnancy: practical suggestions.

Gonsalves, Lilian; Schuermeyer, Isabel

doi:10.3949/ccjm.73.12.1098

Cited by 10 publications

(15 citation statements)

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“…Bütün antidepresanlar bir dereceye kadar süte geçerler ancak etik konulardaki endişeler emziren annelerde etkinlik ve güvenliği belirlemek için geniş randomize kontrollü çalışmaların yapılmasına engel olmaktadır. [52] Çalışmalar bu dönemde kadınların psikolojik ve sosyal girişimleri, farmakoterapiye tercih ettiklerini göstermektedir. [53] Kişilerarası psikoterapi (interpersonel psikoterapi) ve bilişsel davranışçı terapi hafif-orta şiddetli depresyon için etkinliği kanıtlanmış tedavi yaklaşımlarıdır.…”

Section: Perinatal Depresyonda Tedaviunclassified

Interpersonal Psychotherapy in the Treatment of Perinatal Depression

Altın¹

2012

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychia

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ÖZETPerinatal depresyon, akut ve uzun süreli sonuçları sadece anneyi değil, bebeği-ni ve aralarındaki ilişkiyi de etkileyen ama yeterince tanınıp tedaviye yönlendi-rilemeyen bir psikiyatrik rahatsızlıktır. Hem gebelik hem de postpartum dö-nem kişilerarası ilişkileri de etkileyen önemli fiziksel ve duygusal değişimlerin yaşandığı süreçlerdir. Yetersiz sosyal destek ve artmış sosyal çatışma gibi kişile-rarası risk etkenleri bu dönemde kadının ruhsal ve fiziksel sağlığı üzerine ciddi etkiler yapabilir. Çalışmalar bu dönemde kadınların psikolojik ve sosyal girişimleri farmakoterapiye tercih ettiklerini göstermektedir. Kişilerarası psikoterapi, kısa süreli, özellikle kişilerarası sorunlara odaklanan, depresif belirtilerin azalmasını ve kişilerarası işlevselliğin düzelmesini hedefleyen bir tedavi yaklaşımıdır. Gebelik ve doğum sürecinde ortaya çıkan sorunlar kişilerarası terapinin ele aldığı dört temel sorun alanı ile çok uyumlu olduğu için terapist hastanın bu çatışmalarını çözmek için kişilerarası psikoterapiyi rahatlıkla kullanabilir. Anahtar Sözcükler: Perinatal depresyon, kişilerarası psikoterapi, sosyal destek ABSTRACTPerinatal depression is a psychiatric disorder that is not sufficiently diagnosed and directed to treatment. Its acute and chronic outcomes influence not only the mother but also the infant and the relationship between them. Both pregnancy and the postpartum periods are the times of significant physiological and emotional changes which also influence interpersonal relationships. Interpersonal risk factors like insufficient social support and increased social conflict can have an important impact on the women's mental and physiological health during this period. Studies have shown that women prefer psychological and social management over drugs during this period. Interpersonal psychotherapy is a time-limited treatment approach, especially

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Section: Perinatal Depresyonda Tedaviunclassified

Interpersonal Psychotherapy in the Treatment of Perinatal Depression

Altın¹

2012

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychia

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“…Women diagnosed with depression who have been asymptomatic for over a year may wish to attempt to reduce or discontinue their antidepressants a few months before conception and throughout the pregnancy. 57 However, one study found that 60% of women taking antidepressants at the time of their baby's conception had depressive symptoms over the course of the pregnancy. 68 Women should be monitored closely for relapse of depressive symptoms.…”

Section: Treatment Of Depression During Pregnancymentioning

confidence: 99%

“…27 If a woman's depression history contains multiple relapses or severe symptoms, including suicide attempts and multiple inpatient psychiatric admissions, it is recommended that she remain on antidepressants for her own safety, regardless of pregnancy status. 57 …”

Section: Treatment Of Depression During Pregnancymentioning

confidence: 99%

“…All antidepressants are secreted to some degree into the breast milk; however, ethical concerns prevent large randomized controlled trials in lactating mothers to determine efficacy and safety 57 . Both paroxetine and sertraline have been studied in lactating women, and, as with all medications, are secreted into breast milk.…”

Section: Treatment Of Postpartum Depressionmentioning

confidence: 99%

“…Mothers taking any antidepressant should be mindful of their infant's temperament and behavior, especially premature and sick newborns who may be predisposed to dehydration 117 and should notify their physician if they notice irritability, difficulty feeding, or disturbed sleep patterns 57 . In general, no adverse effects are noted in infants when breastfeeding mothers take TCAs 123 .…”

Section: Treatment Of Postpartum Depressionmentioning

confidence: 99%

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When Depression Complicates Childbearing: Guidelines for Screening and Treatment During Antenatal and Postpartum Obstetric Care

Muzik

Marcus

Heringhausen

et al. 2009

Obstetrics and Gynecology Clinics of North America

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Synopsis Prevalence studies show that one in five women experience an episode of major depressive disorder during their lifetime. The peripartum period constitutes a prime time for symptom exacerbation and relapse of depressive episodes. It is important for health care providers, specifically those in obstetric care, to be aware of (1) the frequency of depression in pregnant and postpartum women; (2) signs, symptoms, and appropriate screening methods; and (3) the health risks for the mother and growing fetus if depression is undetected or untreated. Because management of depressed peripartum women also includes care of a growing fetus or breastfeeding infant, treatment may be complex and requires input from a multidisciplinary team, including an obstetrician, psychiatrist, and pediatrician, to provide optimal care.

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Safety Concerns

Kelly

2009

Principles of CNS Drug Development

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A crucial feature of any drug development process is an appraisal of the safety of the drug in humans. The safety of CNS drugs is of particular relevance when we consider the characteristics of the population that will receive them; some of these features are summarised in Table 7.1. The psychopathology of psychiatric conditions means that many patients are at a high risk of taking their own life, and could use their prescribed drugs as a means to commit suicide. In addition, as psychiatric diseases are often diagnosed at an early age, there is the need for pharmacotherapy at the earlier stages of the lifespan, e.g. in children and adolescents. Moreover, older patients will also be likely to receive antidepressants, sedative/hypnotics and antipsychotics, in addition to treatments for the older-onset illnesses such as Alzheimer's and Parkinson's diseases. As psychiatric disease has a high prevalence in young women of child-bearing age, the effects of drug treatment on the developing foetus and the neonate is another important consideration. Most CNS disorders should be viewed as potentially life-long conditions, which as a consequence will require pharmacotherapy for a significant period of the patient's lifespan. The consequences are the potential development of toxicities over a long-term period, which might not be evident following the shorter treatment timeframe that is often employed in premarketing clinical trials. Concomitant administration of drugs to treat comorbid conditions is also extremely common, particularly amongst the older patient populations. These issues will form the basis of this chapter.

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Treating depression in pregnancy: practical suggestions.

Cited by 10 publications

References 0 publications

Interpersonal Psychotherapy in the Treatment of Perinatal Depression

Interpersonal Psychotherapy in the Treatment of Perinatal Depression

When Depression Complicates Childbearing: Guidelines for Screening and Treatment During Antenatal and Postpartum Obstetric Care

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