Postpartum depression can be treated with psychotherapy and medication or any one of them in mild cases. It is necessary to observe the symptoms and signs of depression closely before selecting a line of treatment.
It can be treated in three phases, first acute treatment which is treatment to stabilize the patient and third is maintenance treatment to prevent relapse.
Generally, tricyclic antidepressants and SSRIs are effective but treatment with these drugs leads to some side effects like dry mouth, weight gain, cardiovascular effects and weight gain. These side effects are not desirable during postpartum period. They may prove toxic in case of overdose. The SSRIs have less side effects while MAOIs (Monoamine oxidase inhibitors) are less prescribed because of dietary restrictions.
Patients should be monitored frequently for side effects.
All lactating mothers should be given special consideration. Tricyclic antidepressant does not have any negative effects in infants. Newer SSRIs are yet to be fully evaluated. So it is best to treat lactating mothers with tricyclics and at minimum dose.
Prophylactic treatments for postpartum depression are yet to be established.
Hormonal treatment
Hormonal treatment along with antidepressants can be used to reduce the signs of depression. This includes estrogen replacement therapy. Though studies have shown reduction in symptoms of postpartum depression with estrogen therapy but the role of estrogen in general depression is not known.
The impact of postpartum depression can be decreased by following simple steps. Information about this condition should be an part of prenatal care. Mothering classes should be included. Patients with higher risk should be identified and considered for prophylactic treatment.
Postpartum depression is very frequent problem. Early identification with timely intervention are the keys of successful treatment.