Pharmacotherapy of postpartum obsessive-compulsive disorder: a systematic review

Despite the common occurrence of obsessive-compulsive disorder (OCD) after childbirth, the role of pharmacotherapy in its management is unclear. Areas covered: This systematic review aims to determine the role of drugs in the acute and preventative treatment of postpartum OCD. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, four electronic databases including Medline/PubMed, PsycINFO, the Cochrane Database of Systematic Reviews, and Google Scholar were searched. A total of 10 articles - 1 randomized controlled trial, 2 open-label trials, 1 case series, and 6 case reports - were selected for review. Expert commentary: Currently there are no randomized, placebo-controlled drug trials in the acute or preventative treatment of postpartum OCD. The paucity of studies is surprising given that OCD commonly occurs in the postpartum period and untreated illness can be associated with persistence of OCD symptoms and a high degree of emotional distress. Studies are urgently needed to address the lack of controlled data especially in women with postpartum OCD alone, i.e. without comorbid psychiatric disorders.