Date of Award

5-2021

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Russell Kauffman

Keywords

Postpartum depression; Drug therapy; Physiopathology; Hormone replacement therapy; SSRIs; Brexanolone; Safety; Contraindications; Adverse events

Abstract

Postpartum depression is a mood disorder that includes depressive symptoms during the time period following childbirth. There are various possibilities for what may cause this disorder, but the drastic change in hormones after delivery can play a role. With the chance this disorder may be fatal to both the mother and child, an appropriate, effective, and safe treatment is necessary to control depressive symptoms. The standard, first-line pharmacotherapeutic option is a selective serotonin reuptake inhibitor (SSRI) antidepressant. SSRI antidepressants are well understood, but these medications may take time to become effective. Knowing this, medical professionals can find a more rapid option that would be appropriate; thus, hormone replacement therapy is an alternative. In this review, numerous scientific databases were evaluated, including PubMed, Cochrane, and DynaMed. Keywords and mesh terms were searched to obtain a total of 384 studies. After various exclusion criteria were evaluated, a final total of 19 research articles were included. The results of this literature review showed that both treatment options of SSRI antidepressants and hormone replacement therapy are effective, and various side effects, risks, and contraindications are present with both therapy options. Currently, Brexanolone, an endogenous hormone, is the only FDA-approved indicated medication for postpartum depression. Clinically, psychotherapy and SSRIs are used as first-line options. Further research is necessary to evaluate the effectiveness and possible adverse effects with all options of antidepressants, hormone replacement therapy, and the possibility of a bridge therapy to decrease depressive symptoms.

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