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Navigating Therapies, Challenges, and Recommendations for Treatment-Resistant Peripartum Depression: A Comprehensive
Afshan Zeeshan Wasti1, Sarah Almutairi1, Mohsina Huq1
1Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
Healthcare (Basel, Switzerland)
|October 16, 2025
Summary
Treatment-resistant peripartum depression (TRPD) requires careful management. Non-pharmacological therapies like CBT and exercise offer safe alternatives to medications, balancing maternal health and infant safety.
Area of Science:
- Perinatal Psychiatry
- Neuroscience
- Clinical Psychology
Background:
- Treatment-resistant peripartum depression (TRPD) poses significant challenges globally.
- Balancing maternal symptom relief with fetal/neonatal safety is critical.
Purpose of the Study:
- To review current pharmacological and non-pharmacological interventions for TRPD.
- To highlight mechanisms, efficacy, safety, and practical considerations of treatments.
Main Methods:
- Systematic literature search (PubMed, Cochrane Library, EMBASE) from 2000-2024.
- PRISMA guidelines followed for screening and quality assessment of 142 initial articles, with 67 included.
- Combined MeSH and free-text terms for TRD/TRPD.
Main Results:
- Pharmacological options (SSRIs, brexanolone, zuranolone) show efficacy but carry fetal/neonatal risks.
- Non-pharmacological interventions (CBT, rTMS, exercise) provide safe, evidence-based alternatives.
- Personalized, integrated approaches are optimal for balancing maternal control and perinatal safety.
Conclusions:
- Innovative therapeutics and integrated interventions are key for optimal TRPD care.
- Expanded mental health infrastructure and enhanced research are essential.
- Non-pharmacological methods offer promising avenues for safe and effective TRPD management.
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