Antidepressants are associated with better rates of treatment response and remission for women with postnatal depression, when compared to a placebo, according to a new systematic review by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London.
Reports often focus on the risks of using antidepressants during pregnancy and the postnatal period but this paper, published today in the Journal of the American Medical Association (JAMA), highlights the benefits that antidepressants can have for women with postnatal depression. Postnatal depression occurs in more than 10 per cent of mothers over the first year post-delivery.
Guidelines recommend psychological interventions for mild to moderate depression, and that the risk-benefit ratio of antidepressants (including SSRIs - selective serotonin re-uptake inhibitors) be considered before using them in the postnatal period, including the effect of medication on baby and mother and the likely benefit of psychological intervention.
A systematic review of six randomised controlled trials of 596 women found that antidepressants were of benefit for postnatal depression. The study included a meta-analysis, which involved pooling data from three of the trials. It found that of the 72 women with postnatal depression randomised to treatment with SSRIs, 54 per cent reported 'much improved' symptoms or a more than 50 per cent symptom reduction, compared to 36 per cent of those who were randomised to placebo.
Remission rates (i.e. no longer meeting validated criteria for depression) were also improved, with 49 per cent of participants randomised to SSRIs showing remission compared to 26 per cent in the placebo group. These findings related to a treatment period of between six to eight weeks.
Emma Molyneaux, first author from the IoPPN at King's College London, said:
'Our findings are important due to the limited research exploring the use of antidepressants to treat postnatal depression. We would urge that treatment decisions during the postnatal period consider the potential benefits as well as risks of medication, as well as the risks of untreated depression for both mother and baby.'
Kylee Trevillion, co-author and post-doctoral researcher at the IoPPN, said: 'There have been relatively few trials of antidepressants for postnatal depression and few studies to date have included women with severe depression. Postnatal depression impacts not only the mother but also the rest of the family - more research is needed in this area to improve outcomes for mothers and their families.'
NIHR-funded Professor Louise Howard, senior author from the IoPPN, said: 'Some antidepressants are safer than others for mothers who are breastfeeding, so mothers seeking advice for depressive symptoms should ensure that their doctor knows if they are breastfeeding.'
The authors of this study are funded by the Medical Research Council (MRC), Tommy's baby charity, the National Institute for Health Research (NIHR) and the NIHR Maudsley Biomedical Research Centre.
Paper reference: Molyneaux E, Trevillion K, Howard L M (2015) 'Antidepressant Treatment for Postnatal Depression'. JAMA
For further media information please contact Jack Stonebridge, Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King's College London email@example.com/ (+44) 020 7848 5377
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About National Institute for Health Research
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www.nihr.ac.uk).