MANAGEMENT OF PERIPARTUM DEPRESSION: BETTER, PREVENT THAN TREAT!.

Peripartum depression is one of the common mental illness affecting significant population during that period. The disease morbidity not only affects mother but also baby and spouse. Thus adequate management of this condition, has huge positive impact on the whole family. Treatment and prevention are the two dimensions of managing the ailment. Medications and psychological interventions are being used for both treatment and prevention. Selective serotonin reuptake inhibitors (SSRIs) especially sertraline are the common drugs utilized for treatment. Similarly, estrogens have shown some evidence of efficacy. Though, SSRIs are recommended during peripartum period, psychotherapy which is equally effective holds significance due to its safety profile. Psychological intervention includes psychosocial community-based intervention, cognitive behavioral therapy (CBT), interpersonal therapy (IPT). Exercise and yoga have also shown to be useful for peripartum depression. Saffron and light therapy seems to be of promise which needs to be further explored. Preventive strategies are proved to be effective in managing peripartum depression especially psychological interventions. The American College of Obstetrics and Gynecology (ACOG) and American Academy of Pediatrics (AAP) recommends screening for depression and identifying ?at risk mothers?. Thus prevention of peripartum depression has to be part of optimal antenatal care. The psychological interventions being both safe and effective seems to be the ideal to be used in this setting. Among drugs only sertraline has been shown to be good in preventing episodes of depression. Hence, ?prevention is better than treatment? holds good for peripartum depression especially by psychological interventions. The available evidence for treatment and prevention of peripartum depression is overviewed in this review.