Complementary and alternative medicine for perinatal depression.
BACKGROUND
Perinatal Major Depressive Disorder (MDD) is common and poses particular treatment dilemmas. Complementary and Alternative Medicine (CAM) treatments are widely used, accessible, and understudied for well-defined psychiatric indications. Women are more likely than men to both suffer from MDD and use CAM.


METHODS
A PubMed/Medline search was conducted to assess the evidence base for commonly utilized CAM treatments, MDD, and perinatal depression.


RESULTS
Among CAM treatments, omega-3 fatty acids have received the most specific study in terms of epidemiological, preclinical, and clinical research for perinatal depression. Three randomized placebo-controlled trials have been conducted in which investigators assessed omega-3 fatty acids vs. placebo for perinatal depression, with conflicting results. CAM interventions that can be easily added to a treatment plan with little risk and general health benefits for most women include omega-3 fatty acids, exercise, and folate, although data are insufficient at this time to recommend any of these as monotherapy for perinatal depression. S-adenosyl-methionine (SAMe) and bright light therapy may be reasonable to consider based on the evidence in MDD. St. John's Wort requires further study with regard to safety in pregnancy, and drug interactions can be a potential problem.


CONCLUSIONS
Further study is required to elucidate the role of CAM treatments for perinatal depression, and the clinical context of perinatal depression requires safe, effective, and accessible treatment options.
Freeman
Marlene P
MP
Women's Mental Health Center, University of Texas Southwestern Medical Center, 6363 Forest Park, Suite 800, Dallas, TX 75235-9086, United States. marlene.freeman@utsouthwestern.edu
D015670:Acupuncture Therapy; D000529:Complementary Therapies / Q000379:methods*; D019052:Depression, Postpartum / Q000188:drug therapy / Q000628:therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D005260:Female; D029001:Herbal Medicine; D006801:Humans; D020902:Hypericum / Q000737:chemistry; D010789:Phototherapy; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000628:therapy*; D012436:S-Adenosylmethionine / Q000031:analogs & derivatives / Q000627:therapeutic use
D015525:Fatty Acids, Omega-3; D010936:Plant Extracts; C468227:adenosyl-methionine 1,4-butanedisulfonate; D012436:S-Adenosylmethionine