The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants.
BACKGROUND
Postpartum depression is seen in approximately 13% of women who have recently given birth; unfortunately, it often remains untreated. Important causes for undertreatment of this disorder are providers' and patients' lack of information about the effectiveness of various treatments, and their concerns about the impact of treatment on nursing infants. This article presents research-based evidence on the benefits of various treatments for postpartum depression and their potential risks to nursing infants.


METHODS
The medical literature on postpartum depression treatment was reviewed by searching MEDLINE and Current Contents using such key terms as "postpartum depression," "treatment," "therapy," "psychotherapy," and "breastfeeding."


CONCLUSIONS
There is evidence that postpartum depression improves with antidepressant drug therapy, estrogen, individual psychotherapy, nurse home visits, and possibly group therapy. Of the more frequently studied antidepressant drugs in breastfeeding women, paroxetine, sertraline, and nortriptyline have not been found to have adverse effects on infants. Fluoxetine, however, should be avoided in breastfeeding women. By administering effective treatment to women with postpartum depression, we can positively impact the lives of mothers, their infants, and other family members.
Gjerdingen
Dwenda
D
Department of Family Practice & Community Health, University of Minnesota, St. Paul 55103, USA. dgjerdin@umphysicians.umn.edu
D000928:Antidepressive Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001942:Breast Feeding; D003376:Counseling; D019052:Depression, Postpartum / Q000175:diagnosis / Q000628:therapy*; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006699:Home Care Services; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D011613:Psychotherapy / Q000379:methods
D000928:Antidepressive Agents; D004967:Estrogens