Depression during pregnancy

Cohen LS, Nonacs R, Viguera AC, Reminick A. Diagnosis and treatment of depression during pregnancy. CNS Spectr 2004 9 209-216. 

Electroconvulsive therapy (ECT) is used for severe mania or depression during pregnancy and for mixed episodes prior to treatment, anticonvulsants, lithium, and benzodiazepines should be tapered off to maximize therapy and minimize adverse effects. 

Electroconvulsive therapy, an effective treatment for depression during pregnancy (Eorssman, 1955 Impastato et ah, 1964), should be considered when other... 

O Hara, M.W. (1986) Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry 43 569— 573. 

Wisner KL, Gelenberg AJ, Leonard H, Zarin D, Frank E. Pharmacologic treatment of depression during pregnancy. JAMA 1999 282(13) 1264-9. 

Approximately 10% of pregnant women develop a serious depression during pregnancy. No major teratogenic effects are currently... 

Hendrick V, Altshuler L. Management of major depression during pregnancy. Am J Psychiatry 2002 159 1667-1673. 

Nonacs R, Cohen LS. Depression during pregnancy Diagnosis and treatment options. J CUn Psychiatry 2002 63(suppl 7) 24-30. 

Safety through the Life Cycle Most antidepressants appear to be safe during pregnancy. Most antidepressants and lithium are secreted in breast milk, at least in small quantities, and their safety in nursing infants is neither established nor safely assumed. For severe depression during pregnancy and lactation, EOT can be a relatively safe and effective alternative. 

Parry BL. Assessing risk and benefit to treat or not to treat major depression during pregnancy with antidepressant medication. Am J Psychiatry 2009 166(5) 512-4. 

---