Somatic Treatments in Treatment of Depression During Pregnancy
Year 2015,
Volume: 7 Issue: 3, 244 - 254, 12.07.2015
Eylem Özten
,
Gökben Hızlı Sayar
Abstract
Although some psychotropic drugs are known to be teratogenic no psychotropic drug is of proven safety for treatment of depression during pregnancy. Untreated mood disorders during pregnancy pose significant risks for mother and the newborn. This review focuses on the use of somatic tretments of depression during pregnancy.Electroconvulsive therapy, bright light therapy, transcranial magnetic stimulation and vagal nerve stimulation are relatively safe and effective treatments during pregnancy if steps are taken to decrease potential risks. A clear information related to the somatic treatment should be given to the patient and informed consent should be obtained.
References
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Gebelikte Depresyonun Somatik Tedavisi
Year 2015,
Volume: 7 Issue: 3, 244 - 254, 12.07.2015
Eylem Özten
,
Gökben Hızlı Sayar
Abstract
Psikotrop ilaçların bir kısmının gebelikte kullanımının teratojenik olduğu bilinmesine rağmen, gebelikte depresyon tedavisinde tamamen güvenli olduğu kanıtlanmış bir tedavi yöntemi bulunmamaktadır. Gebelikte yeterince tedavi edilmeyen duygudurum bozuklukları hem anne hem de yenidoğan için önemli riskler oluşturmaktadır. Bu yazıda gebelikte depresyon tedavisinde kullanılabilecek somatik tedaviler incelenmiştir. Elektrokonvülsif tedavi, parlak ışık tedavisi, transkranial manyetik stimülasyon ve vagal sinir stimülasyonu, potansiyel riskleri azaltmak için gerekli önlemler alındığında gebelik sırasında nispeten güvenli ve etkili tedavilerdir. Gebelikte depresyon tedavisinde somatik tedaviler uygulanacağında mutlaka hastanın anlayacağı biçimde detaylı bilgi verilmeli, bilgilendirilmiş onamı alınmalıdır.
References
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- DeBattista C, CochranM, Barry JJ, Brock-Utne JG (2003) Fetal heart rate decelerations during ECT-induced seizures: is it important? Acta Anaesthesiol Scand, 47:101–103.
- Ding Z, White PF (2002) Anesthesia for electroconvulsive therapy. Anesth Analg, 94:1351-1364.
- Dodd S, Berk M (2006) The safety of medications for the treatment of bipolar disorder during pregnancy and the puerperium. Curr Drug Saf, 1:25-33.
- El Marroun H, Jaddoe VW, Hudziak JJ, Roza SJ, Steegers EA, Hofman A et al. (2012) Maternal use of selective serotonin reuptake inhibitors, fetal growth, and risk of adverse birth outcomes. Arch Gen Psychiatry, 69:706-714.
- Epperson CN, Terman M, Terman JS, Hanuba BH, Oren DA, Peindl KS et al. (2004) Randomized clinical trial of bright light therapy for antepartum depression:preliminary findings. J Clin Psychiatry, 65:421-425.
- Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ, 323:257-260.
- Evans J, Melotti R, Heron J, Ramchandani P, Wiles N, Murray L et al. (2011) The timing of maternal depressive symptoms and child cognitive development: a longitudinal study. J Child Psychol Psychiatry, 23:632-640.
- Fitzgerald PB, Daskalakis ZJ (2011) The effects of repetitive transcranial magnetic stimulation in the treatment of depression. Expert Rev Med Devices, 8:85-95.
- Frassetto F, Tourneur-Martel F, Barjhoux CE, Villier C, Bot BL, Vincent F (2002) Goiter in a new born exposed to lithium in utero. Ann Pharmacother, 36:1745-1748.
- Freeman RK, Garite TJ, Nageotte MP (2003) Fetal Heart RateMonitoring. 3rd ed. Baltimore, Lippincott Williams&Wilkins.
- Fukuchi T, Okada Y, Katayama H, Nishijima K, Kato S, Netsu S (2003) A case of pregnant woman with severe obsessivecompulsive disorder successfully treated by modified electroconvulsive therapy. Seishin Shinkeigaku Zassh, 105:927-932.
- Gahr M, Blacha C, Connemann BJ, Freudenmann RW, Schonfeldt- Lecuona C (2012) Successful treatment of major depression with electroconvulsive therapy in a pregnant patient with previous nonresponse to prefrontal rTMS. Pharmacopsychiatry, 45:79– 80.
- Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G et al. (2005). Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess, 119:1-8.
- Graff LA, Dyck DG, Schallow JR (1991) Predicting postpartum depressive symptoms and structural modelling analysis. Percep Mot Skills, 73:1137–1138.
- Handforth A, DeGiorgio CM, Schachter SC, Uthman BM, Naritoku DK, Tecoma ES et al. (1998) Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology, 51:48-55.
- Herman NL, Li AT, Van Decar TK, Johnson RF, Bjoraker RW, Downing JW, Jones D (2000) Transfer of methohexital across the perfused human placenta. J Clin Anesthes, 12:25–30.
- Hızlı Sayar G, Ozten E, Tufan E, Cerit C, Kağan G, Dilbaz N et al. (2014) Transcranial magnetic stimulation during pregnancy. Arch Womens Ment Health, 17:311-315.
- Hollins K (2007) Consequences of antenatal mental health problems for child health and development. Curr Opin Obstet Gynecol, 19:568-572.
- Husain MM, Stegman D, Trevino K (2005) Pregnancy and delivery while receiving vagus nerve stimulation for the treatment of major depression: a case report. Ann Gen Psychiatry, 4:16.
- Ishikawa T, Kawahara S, Saito T, Otsuka H, Kemmotsu O, Hirayama E et al. (2001) Anesthesia for electroconvulsive therapy during pregnancy - a case report. Masui, 50:991–997.
- Iwasaki K, Sakamoto A, Hoshino T, Ogawa R (2002) Electroconvulsive therapy with thiamylal or propofol during pregnany Can J Anesth, 49:324-325.
- Jauniaux E, Gulbis B, Shannon C (1998) Placental propofol transfer and fetal sedation during maternal general anaesthesia in early pregnancy. Lancet, 352:290–291.
- Källén B, Olausson PO ( 2008) Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf, 17:801-6.
- Kieler H, Artama M, Engeland A, Ericsson O, Furu K, Gissler M et al. (2012) Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. BMJ,12;344.
- Kim DR, Epperson N, Paré E, Gonzalez JM, Parry S, Thase ME et al. (2011) An open label pilot study of transcranial magnetic stimulation for pregnant women with major depressive disorder. J Women's Health, 20:255-261.
- Kim DR, Sockol L, Barber JP, Moseley M, Lamprou L, Rickels K et al. (2011) A survey of patient acceptability of repetitive transcranial magnetic stimulation (TMS) during pregnancy. J Affect Disord, 129:385–390.
- Klirova M, Novak T, Kopecek M, Mohr P, Strunzova V (2008) Repetitive transcranial magnetic stimulation (rTMS) in major depressive episode during pregnancy. Neuro. Endocrinol. Lett, 29:69–70.
- Kozma C (2005). Neonatal toxicity and transient neurodevelopmental deficits following prenatal exposure to lithium: Another clinical report and a review of the literature. Am J Med Genet A, 132:441-444.
- Kripke DF, Mullaney DJ, Klauber MR, Risch SC, Gillin JC (1992) Controlled trial of bright light for nonseasonal major depressive disorders. Biol Psychiatry, 31:119-134.
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