Postpartum Depression Flashcards
when must depression occur to be dx
within 4 wks of birth
postpartum depression
Similar to other major and minor depressions
Symptoms must be present most all of the day or all day
for 2 wks
develops in 10-15%
post partum blues (50-80% of mothers)
due to lack of major symptoms not classified as a disorder
Usually onset day 4 post delivery and resolved by day 10
transient state of tearfulness, anxiety, irritation, and
restlessness
Symptoms DO NOT interfere with the mother’s ability to
care for her newborn
Symptom lasting longer than 2 weeks suggest postpartum
depression
clinical presentation of psychosis
Dramatic onset emerging early and intensely
Resembles rapidly evolving manic episode with symptoms
of restlessness, insomnia, irritability, rapidly shifting
depression or elated mood, disorganized behavior.
Mother may have delusional beliefs regarding the infant or
auditory hallucinations that instruct her to harm herself
or the child
High risk for infanticide or suicide
tx of postartum depression
Rule out thyroid dysfunction and anemia
The severity of the illness should guide treatment
Non-pharmacologic treatment are useful for mild to
moderate symptoms: support groups or individual or
group therapy
Pharmacologic therapy is indicated in moderate to severe
cases
tx for postpartum blues
supportive
blues vs depression
blues- does not affect caring for you child
depression - can affect caring for your child
drugs for post partum depression
Depressive symptoms: SSRI’s (Zoloft) are first line therapy
and SNRI’s are second
Sleep disturbance: tri-cyclic antidepressants
Severe anxiety: short (wk or less) course of lorazepam or
clonazepam
Estrogen patches suggested but SSRI’s are still drug of
choice
antidepressant tx that are relatively safe during breastfeeding from a study
Amitriptyline, nortriptyline, desipramine, clomipramine, dothiepin, and sertraline
