Pharmacologic Treatment of Perinatal Depression

Obstet Gynecol Clin North Am. 2018 Sep;45(3):419-440. doi: 10.1016/j.ogc.2018.04.007.

Abstract

This review provides information about medications used to treat perinatal depression, including guidance around when to use certain medications and when to consult a mental health provider. For each group of medications, including selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, mirtazapine, bupropion, lithium, atypical antipsychotics, and lamotrigine, the risks and benefits of treatment during pregnancy and lactation are reviewed, and unique qualities of each medication. A treatment algorithm is included and a description of the Food and Drug Administration's approach to providing information about medications. The article also discusses hormone therapies and future directions for new pharmacologic treatments.

Keywords: Depression; Medication; Mental health; Peripartum; Treatment considerations.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Clinical Decision-Making
  • Contraindications
  • Depression / drug therapy*
  • Female
  • Humans
  • Practice Patterns, Physicians' / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / psychology
  • Pregnant People / psychology*
  • Prenatal Exposure Delayed Effects / prevention & control
  • Psychotherapy
  • Risk Assessment

Substances

  • Antidepressive Agents
  • Antipsychotic Agents