Fluvoxamine for Postpartum Depression
2001; American Psychiatric Association; Volume: 158; Issue: 10 Linguagem: Português
10.1176/appi.ajp.158.10.1739
ISSN1535-7228
AutoresRita Suri, Vivien K. Burt, Lori L. Altshuler, Joni Zuckerbrow-Miller, Lynn A. Fairbanks,
Tópico(s)Attention Deficit Hyperactivity Disorder
ResumoBack to table of contents Previous article Next article Letter to the EditorFull AccessFluvoxamine for Postpartum DepressionRITA SURI, M.D., VIVIEN K. BURT, M.D., PH.D., LORI L. ALTSHULER, M.D., JONI ZUCKERBROW-MILLER, A.A., and LYNN FAIRBANKS, PH.D., RITA SURI, M.D., VIVIEN K. BURT, M.D., PH.D., LORI L. ALTSHULER, M.D., JONI ZUCKERBROW-MILLER, A.A., and LYNN FAIRBANKS, PH.D., Los Angeles, Calif.Published Online:1 Oct 2001https://doi.org/10.1176/appi.ajp.158.10.1739AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: To our knowledge, only two studies have systematically examined the treatment of postpartum depression with standard antidepressants. One found that fluoxetine or cognitive behavior therapy was effective for treatment of major or minor depression appearing in the first 8 postpartum weeks (1). In another open study, sertraline was found to be effective for treatment of major depression occurring within 6 months of delivery (2).We report on an 8-week, open-label trial of six subjects, approved by the University of California at Los Angeles institutional review board. Primary inclusion criteria consisted of outpatient status, female sex, age between 18 and 45 years, onset of major depression in the first 8 postnatal weeks, and scores of 17 or higher on the 21-item Hamilton Depression Rating Scale and 12 on the Edinburgh Postnatal Depression Scale (3). Subjects with an onset of depression during pregnancy, the presence of psychosis, active suicidal ideation, hypothyroidism, or a history of alcohol or substance abuse within the 12 months before screening were excluded from the study. We obtained written informed consent from all subjects after the study had been explained to them. Subjects began fluvoxamine treatment, 50 mg/day, and were followed with weekly clinical interviews and administration of the Hamilton depression rating scale by a blind rater. Over the first 2 weeks of the study, fluvoxamine doses were titrated to 150 mg/day to achieve clinical response with minimal or no side effects. The primary outcome variable was remission, operationalized as a Hamilton depression scale score of 7 or less.Statistical analysis of response was performed for all six subjects. Data analysis included the last observation carried forward for a nonresponder who discontinued treatment at week 5. Four subjects (67%) became euthymic, with a mean time to response of 6 weeks (SD=1). Final Hamilton depression scale scores ranged from 2 to 5 for the four responders and 16 to 18 for the two nonresponders. Baseline demographic characteristics and severity of depression did not differ between responders and nonresponders. Past history of depression or prior response to treatment were not predictive of treatment response. The mean final daily dose of fluvoxamine for all subjects was 142 mg/day (SD=20) (150 mg/day for the three responders and both nonresponders and 100 mg/day for one responder). Repeated measures analysis of variance indicated a significant linear decline in Hamilton depression scale scores over time (F=12.00, df=1, 5, p=0.02). Paired t tests demonstrated that the greatest degree of improvement occurred between weeks 2 and 3 (t=5.48, df=5, p=0.003).Our findings, although limited by our small group size, the single-blind study design, and the lack of a placebo control group, suggest that fluvoxamine is effective in the treatment of postpartum depression. Given the prevalence and complications of postpartum depression, future large-scale studies are warranted.References1. Appleby L, Warner R, Whitton A, Faragher B: A controlled study of fluoxetine and cognitive-behavioural counselling in the treatment of postnatal depression. Br Med J 1997; 314:932-936Crossref, Medline, Google Scholar2. Stowe ZN, Casarella J, Landry J, Nemeroff CB: Sertraline in the treatment of women with postpartum major depression. Depression 1995; 3:49-55Crossref, Google Scholar3. Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression: development of the Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150:782-786Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited byTreating Postpartum Depression: What Do We Know about Brexanolone?12 July 2021 | Diseases, Vol. 9, No. 3Predictors of response to antidepressants in women with postpartum depression: a systematic review16 June 2020 | Archives of Women's Mental Health, Vol. 23, No. 5Advances in treatment for postpartum major depressive disorder25 June 2020 | Expert Opinion on Pharmacotherapy, Vol. 21, No. 14Postpartum DepressionObstetrics and Gynecology Clinics of North America, Vol. 47, No. 3Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development21 February 2019 | CNS Drugs, Vol. 33, No. 3Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, Vol. 39, No. 11Postpartum Depression in Women with Normal Delivery and Cesarean Section Referring to Sayad Shirazi Hospital of Gorgan , Iran1 January 2019 | Journal of Research Development in Nursing and Midwifery, Vol. 16, No. 1Frontiers in Psychiatry, Vol. 10Clinical Psychology Review, Vol. 66Gastrointestinal Side Effects in the Baby of a Breastfeeding Woman Treated with Low-Dose Fluvoxamine20 April 2015 | Journal of Human Lactation, Vol. 31, No. 3Treatment of postnatal depression with cognitive behavioural therapy, sertraline and combination therapy: A randomised controlled trial13 January 2015 | Australian & New Zealand Journal of Psychiatry, Vol. 49, No. 3Archives of Women's Mental Health, Vol. 18, No. 1Neuroscience & Biobehavioral Reviews, Vol. 52Postpartum psychiatric disorders: Early diagnosis and managementIndian Journal of Psychiatry, Vol. 57, No. 6Selective serotonin reuptake inhibitors (SSRIs) for post-partum depression (PPD): A systematic review of randomized clinical trialsJournal of Affective Disorders, Vol. 152-154Management of Postpartum Depression16 October 2013 | Journal of Midwifery & Women's Health, Vol. 58, No. 6Archives of Women's Mental Health, Vol. 16, No. 5Psychiatric Disorders and PregnancyJournal of Affective Disorders, Vol. 125, No. 1-3Psychiatric Clinics of North America, Vol. 33, No. 2Bipolar Disorders, Vol. 12, No. 3Pharmacotherapy, Vol. 30, No. 9Expert Opinion on Pharmacotherapy, Vol. 10, No. 16Prévention et traitement de la dépression du post-partumDevenir, Vol. Vol. 20, No. 3Archives of Women's Mental Health, Vol. 11, No. 5-6Neuroscience and Behavioral Physiology, Vol. 38, No. 4Breastfeeding Medicine, Vol. 3, No. 1Pilot study of fluvoxamine treatment for climacteric symptoms in Japanese women5 June 2007 | BioPsychoSocial Medicine, Vol. 1, No. 1Psychosocial and psychological interventions for treating postpartum depression17 October 2007 | Cochrane Database of Systematic Reviews, Vol. 314Antidepressant Use in the Postpartum Period: Practical ConsiderationsJennifer L. Payne, M.D.1 September 2007 | American Journal of Psychiatry, Vol. 164, No. 9Psychiatric DisordersThe Lancet, Vol. 370, No. 9599Archives of Psychiatric Nursing, Vol. 21, No. 2Legal and Ethical Considerations: Risks and Benefits of Postpartum Depression Screening at Well-Child Visits1 January 2007 | Pediatrics, Vol. 119, No. 1Expert Review of Neurotherapeutics, Vol. 7, No. 5Postpartum DepressionJournal of Clinical Psychopharmacology, Vol. 26, No. 4Treating Depression During Pregnancy and the Postpartum: A Preliminary Meta-Analysis19 August 2016 | Research on Social Work Practice, Vol. 16, No. 2Archives of Women's Mental Health, Vol. 9, No. 6Prostaglandins, Leukotrienes and Essential Fatty Acids, Vol. 75, No. 4-5Bipolar Disorders, Vol. 8, No. 4Women's Health Medicine, Vol. 3, No. 2Pharmacologic and Hormonal Treatments for Postpartum DepressionPsychiatric Annals, Vol. 35, No. 7American Journal of Obstetrics and Gynecology, Vol. 192, No. 2CNS Spectrums, Vol. 10, No. 12Journal of Obstetric, Gynecologic & Neonatal Nursing, Vol. 34, No. 2Expert Opinion on Pharmacotherapy, Vol. 6, No. 12Psychiatry, Vol. 3, No. 10Novel Uses of Selective Serotonin Reuptake Inhibitors in Women30 June 2016 | Journal of Pharmacy Practice, Vol. 16, No. 3Treatment of depression associated with the menstrual cycle: premenstrual dysphoria, postpartum depression, and the perimenopause1 April 2022 | Dialogues in Clinical Neuroscience, Vol. 4, No. 2Journal of Women's Health & Gender-Based Medicine, Vol. 10, No. 10 Volume 158Issue 10 October 2001Pages 1739-1740 Metrics History Published online 1 October 2001 Published in print 1 October 2001
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