Perinatal Mood Disorders Flashcards
Barker Hypothesis
intrauterine environment is first human environment - what happens here is impactful
List the impacts of untreated depression on fetus
- PTB
- low birth weight
- fetal growth restriction
- increased fetal mental health problems
- behavioral problems
List risk factors for perinatal depression
- prior hx of depression/anxiety
- limited supportive resources
- being female
- excessive life stress
- undesired pregnancy
- IPV
- smoking
- low level education
- low SES
- single parent
What s/sx should be addressed?
- feelings of worthlessness, despair, isolation
- trouble sleeping
- somatic complaints
- excessive fatigue
- weight change not related to pregnancy
- limited eye contact
- flat affect
- suicidal ideation
mild to moderate depression management
- if wants to d/c meds, counsel on non-pharm options (e.g. yoga, light therapy, CBT, exercise, massage)
- withdrawal should be slow
moderate to severe depression management
*pts suffer greater risk of relapse if d/c meds in pregnancy
FIRST LINE: SSRIs and venlafaxine (Categories C)
What is most commonly prescribed for PMDs?
setraline (Zoloft) - lowest amounts found in breast milk
Which drug has the highest amounts in breastmilk?
fluoxetine (Prozac)
What are the contraindications against bupropion?
norepinephrine and dopamine re-uptake inhibitor
Category C
- anxiety, panic
- seizure disorders (lowers threshold)
Why is paroxetine (Paxil) not recommended in pregnancy?
cardiac malformation risk
Category D
When is the riskiest time for PPD?
9-12mo PP
