Pharmacological prophylaxis of postpartum exacerbation in depressive and anxiety symptoms: a retrospective study

The aim of this study was to investigate the efficacy of prophylactic treatment with antidepressants for the prevention of postpartum exacerbation in depressive or anxiety symptoms. The study included data on 33 patients who were followed from pregnancy to the postpartum period at the Department of Psychiatry of a university Hospital. Psychiatric diagnoses were determined by means of a structured clinical interview. The severity of depressive and anxiety symptoms were assessed by means of Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A), respectively. Prophylactic treatment was initiated within the first 3 days after the delivery. The patients were assessed again with HAM-D and HAM-A at 4-week postpartum. Postpartum prophylaxis was carried out with administration of sertraline at 50 mg/day (n = 7, 21.2%), paroxetine at 20 mg/day (n = 24, 72.7%), and escitalopram at 10 mg/day (n = 2, 6.1%). Statistical analyses indicated that the mean HAM-D and HAM-A scores before (9.45 ± 7.01 and 10.09 ± 6.42, respectively) and after (9.09 ± 6.65 and 9.54 ± 5.97, respectively) the delivery were not significant. Results of the present study suggest that prophylactic use of antidepressants following parturition may be useful in the prevention of postpartum exacerbation of symptoms in women with depression or anxiety disorders.