Treatment of perinatal mood and anxiety disorders: a review.
OBJECTIVE
To review the nonpharmacologic and pharmacologic treatment modalities for perinatal mood and anxiety disorders and to discuss the importance of weighing the risks and the benefits of exposing the fetus or baby to maternal mental illness as opposed to exposure to antidepressant medications.


METHODS
We conducted a literature search of the PubMed and MEDLINE databases. Key words included the following: perinatal, pregnancy, postpartum, depression, anxiety, pharmacologic, nonpharmacologic, psychotherapy, and treatment.


RESULTS
Recent literature reflects that both pharmacologic and nonpharmacologic treatments for perinatal women are associated with positive and negative outcomes. No treatment decision was found to be risk-free. The detrimental effects of untreated mental illness on the mother, as well as on the baby, highlight the need for treatment intervention. The long-term effects of exposure to either medications or maternal mental illness are unknown, as yet.


CONCLUSIONS
Women with perinatal depression and anxiety disorders require timely and efficient management with a goal of providing symptom relief for the suffering mother while simultaneously ensuring the baby's safety. Although knowledge in the area of appropriate intervention is constantly evolving, rigorous and scientifically sound research in the future is critical.
Misri
Shaila
S
University of British Columbia, Vancouver. smisri@providencehealth.bc.ca
Kendrick
Kristin
K
D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000188:drug therapy / Q000628:therapy*; D019052:Depression, Postpartum / Q000628:therapy*; D005260:Female; D006801:Humans; D019964:Mood Disorders / Q000628:therapy*; D010789:Phototherapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors