Epidemiologic studies suggest that about 10% to 15% of women suffer from clinically significant depressive symptoms during pregnancy. Little is known, however, about the prevalence of depression among women with high risk pregnancies. A recent study published online in the Journal of Clinical Psychiatry suggests that this population may be at significant risk for antenatal depression.
One treatment that has recently received a great deal of interest lately is fish oil. There is some preliminary evidence to suggest that the omega-3 fatty acids contained in fish and fish oil, including eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have an antidepressant effect. It has been discovered that mothers selectively transfer DHA to their baby during pregnancy and through the breast milk to support neurological development in the developing child. Thus, child-bearing women may become depleted of DHA, and it has been hypothesized that DHA deficiency may make mothers more vulnerable to depression during the postpartum period.
Seeking women between 18-45 with PMS who have been diagnosed with depression. If you are between 18 and 45 and:
Electroconvulsive therapy (ECT) is one of the most effective treatments for depression, with response rates that are consistently higher than those observed in clinical trials of antidepressants. Furthermore, ECT may be more effective than medications for treatment-refractory depression. The American Psychiatric Association (APA) recommends ECT for patients who have had previous positive response to ECT or who are non-responsive to pharmacological treatments, as well as for those patients who experience severe psychiatric symptoms, including depression with psychosis. suicidal ideation, and mania.
Vagus Nerve Stimulation, or VNS, has been available for the treatment of epilepsy since 1997 and was approved by the FDA for the adjunctive treatment of refractory depression in 2005. VNS relies upon the use of a surgically implanted device which delivers periodic stimulation to the vagus nerve. How VNS therapy works is not completely understood; however, several studies have suggested that this technique may be effective for some patients with treatment-resistant depression.
Both antidepressant medications and cognitive therapy have been shown to be effective for the treatment of depression; however, the question remains as to whether one treatment is preferred over the other. Subjects enrolled in The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (men and women with major depression, ages 18-75) were initially treated with citalopram, an SSRI. Those who had unsatisfactory outcomes after initial treatment were eligible for a randomized second-step treatment trial in which they switched to a new treatment (either cognitive therapy or a different antidepressant) or augmented the citalopram regimen with either cognitive therapy or a different antidepressant.
Most women experience some degree of sleep disturbance during pregnancy, and for a significant number of women sleep disruption may be quite severe. There are many different causes for sleep disturbance during pregnancy, and choosing the appropriate intervention relies on an accurate diagnosis of the problem.
Depression is common during pregnancy, affecting 10% to 15% of women. While psychotherapy is an attractive option for the treatment of depression during pregnancy, all women do not respond to this intervention and many require pharmacotherapy. Thus far, no antidepressants have yet been approved by the FDA for use during pregnancy. Although data accumulated over the past 30 years suggest that certain medications, including the serotonin reuptake inhibitors (SSRIs), may be used safely during pregnancy, several new studies have raised concerns regarding the use of these medications during pregnancy.
There are data to support the use of certain antidepressants during pregnancy. Most of the research over the last decade has focused on the selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and the older tricyclic antidepressants, but there is some new data supporting the use of bupropion during pregnancy.
