Questões críticas para o tratamento farmacológico da depressão pós-parto

Abstract

Context: Postpartum depression (PPD) is a frequent complication of childbirth, with com- plexities in its clinical management. Objective: In this review article, we propose clinical questions which are relevant to the pharmacological treatment of PPD. Method: Searches were performed in MEDLINE, PsychInfo, CINAHL, Biological Abstracts, Lilacs and in the Cochrane Central Register of Controlled Trials. Results: Current treatment guidelines for the treatment of depression apply to women with PPD which are not breastfeeding. Signi- ficant antidepressant levels are more often detected in children exposed to fluoxetine or citalopram. In those who are exposed, untoward effects and reduced growth are possible. Conclusions: Until the impact of antidepressant exposure through breastfeeding is better understood, a possible clinical approach would be to prescribe antidepressants generally not detected in the infants’ plasma, such as sertraline or paroxetine.