Diagnosis and Treatment of Postpartum Depression: A Review

Abstract

Pregnancy is a period in which physiological, psychological and social changes are experienced in female life. These changes can cause various mental illnesses during and after pregnancy. Postpartum depression is commonly seen in the perinatal period. Postpartum depression is an important cause of morbidity and mortality for mother and baby. A major depressive episode with peripartum onset is defined as postpartum depression when it occurs during pregnancy or up to 4 weeks of postpartum. The frequency of the disease is extremely high. Biological, psychological and sociocultural factors have been reported to be effective in the etiology. It presents with major depression symptoms such as depression, anhedonia, thoughts of guilt, irritability, concentration disorder, psychomotor agitation, psychomotor retardation, sleep disorder, appetite and weight changes. There are many different options in the treatment. Most of these options have been adapted from the treatment of major depression. Serotonin reuptake inhibitors (SSRI), serotonin noradrenaline reuptake inhibitors (SNRIs), tricyclic antidepressants, estradiol, progesterone, psychotherapies, electronvulsive therapy and brexanolone may be used in the treatment. Brexanolone is a promising new drug in the treatment of postpartum depression. It is the only treatment in postpartum depression that has received special indication. This review aims to investigate the recent developments in the etiology, diagnosis and treatment of postpartum depression in the light of current data.

Keywords

• Postpartum depression,depression,treatment,brexanolone

Doğum Sonrası Depresyonun Tanı ve Tedavisi: Bir Gözden Geçirme

Abstract

Gebelik dönemi kadın yaşamında fizyolojik,  ruhsal ve sosyal değişimlerin yaşandığı bir dönemdir. Gebelik dönemi ve sonrasındaki bu değişimler çeşitli ruhsal hastalıklara sebep olabilmektedir. Bu hastalıklardan doğum sonrası depresyon perinatal dönemde sık görülmektedir. Doğum sonrası depresyon anne ve bebek için önemli bir morbidite ve mortalite sebebidir. Peripartum başlangıçlı bir major depresif epizod hamilelikte ve ya doğum sonrası 4 haftaya kadar ortaya çıktığında doğum sonrası depresyon olarak tanımlanmaktadır. Sıklığı son derece yüksektir. Etyolojisinde biyolojik, psikolojik ve sosyokültürel faktörlerin etkili olduğu bildirilmektedir. Çökkünlük, anhedoni, suçluluk düşünceleri, sinirlilik, konsantrasyon bozukluğu, psikomotor ajitasyon, psikomotor retardasyon, uyku düzensizliği, iştah ve kilo değişiklikleri gibi major depresyon semptomları ile prezante olur. Tedavisinde ise bir çok farklı seçenek bulunmaktadır. Bu seçeneklerin çoğu major depresyon tedavisinden uyarlanmıştır. Tedavide serotonin geri alım inhibitörleri (SSRI), serotonin noradrenalin geri alım inhibitörleri (SNRI), trisiklik antidepresanlar, östradiol, progesteron, psikoterapiler, elektronvulsiv terapi ve brexanolone kullanılabilmektedir. Brexanolone doğum sonrası depresyon tedavisinde umut vaat eden  yeni bir ilaçtır. Doğum sonrası depresyona özel endikasyon almış tek tedavidir. Bu derleme çalışması, güncel veriler ışığında doğum sonrası depresyonun etyoloji,  tanı ve tedavisindeki yeni gelişmeleri incelemeyi amaçlamaktadır.

Keywords

• Doğum sonrası depresyon,depresyon,tedavi,Brexanolone

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