Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe

Sarah Kittel-Schneider, Ethel Felice, Rachel Buhagiar, Mijke Lambregtse- van den Berg, Claire A. Wilson, Visnja Banjac Baljak, Katarina Savic Vujovic, Branislava Medic, Ana Opankovic, Ana Fonseca and Angela Lupattelli
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Sarah Kittel-Schneider: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, D-97080 Würzburg, Germany
Ethel Felice: Department of Psychiatry, Faculty of Medicine & Surgery Msida, University of Malta, 2080 Majjistral, Malta
Rachel Buhagiar: Health-Mental Health Services, 2080 Majjistral, Malta
Mijke Lambregtse- van den Berg: Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
Claire A. Wilson: Section of Women’s Mental Health, King’s College London, London SE5 8AF, UK
Visnja Banjac Baljak: Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, 78000 Banjaluka, Bosnia and Herzegovina
Katarina Savic Vujovic: Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, P.O. Box 38, 11129 Belgrade, Serbia
Branislava Medic: Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, P.O. Box 38, 11129 Belgrade, Serbia
Ana Opankovic: Clinic for Psychiatry, University Clinical Center, 11000 Belgrade, Serbia
Ana Fonseca: Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
Angela Lupattelli: PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway

IJERPH, 2022, vol. 19, issue 4, 1-17

Abstract: This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers’ compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers’ compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.

Keywords: clinical practice guideline; depression; anxiety; antidepressant; psychotropic medications; peripartum (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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