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Identification of bipolar disorder in women with postpartum depression
Author(s) -
Sharma Verinder,
Khan Mustaq
Publication year - 2010
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2010.00809.x
Subject(s) - postpartum depression , context (archaeology) , bipolar disorder , depression (economics) , clinical global impression , psychiatry , medicine , mood disorders , antidepressant , mood , psychology , pregnancy , anxiety , placebo , alternative medicine , paleontology , genetics , macroeconomics , pathology , economics , biology
Sharma V, Khan M. Identification of bipolar disorder in women with postpartum depression.
Bipolar Disord 2010: 12: 335–340. © 2010 The Authors.
Journal compilation © 2010 John Wiley & Sons A/S. Objective: No studies to date have assessed the pharmacological management of treatment‐resistant postpartum depression. We reviewed the pharmacological treatment of postpartum depression in patients diagnosed with treatment‐resistant ‘unipolar’ depression. Methods: We conducted a chart review of patients treated consecutively at a perinatal clinic. Treatment‐resistant postpartum depression was defined as a failure to respond to at least one adequate antidepressant trial. Patients were diagnosed using the DSM‐IV criteria, and the Clinical Global Impression–Improvement (CGI‐I) rating scale was used to assess response to various pharmacological interventions. Results: The majority of patients (57%, 34/60) referred for postpartum depression actually suffered from bipolar disorder. All patients were on antidepressants at the time of referral, but by the end of the study 37% (22/60) continued on antidepressants alone or in combination with other medications. CGI‐I ratings showed appreciable improvement in depression at the end of six months following the initial consultation. Very much improvement was noted in 65% (39/60) of patients, and 22% (13/60) were considered much improved. The most common change in medication was a switch to or addition of an atypical neuroleptic. Limitations: Retrospective design, small sample size, and lack of a control group. Conclusions: Management of treatment resistance in women with postpartum depression should be considered within the context of types of mood disorders. Atypical neuroleptics and mood stabilizers used alone or as adjuncts should be considered in the treatment of resistant postpartum depression in patients with a bipolar diathesis.