Advancements in the Treatment of Perinatal Mental Illness: Innovative and Promising Approaches | Chapter 14 | Medical Science: Recent Advances and Applications Vol. 2

Background and Objective: Around the world, pregnant and postpartum women are susceptible to perinatal mental illnesses, such as depression, anxiety, and posttraumatic stress disorder (PTSD). Excessive stress, violence, trauma, and lack of support are common causes. Psychotherapy and antidepressants are the standard treatment for depression during pregnancy or postpartum. However, several new treatments for depression represent major advances and paradigm changes. This commentary highlights some innovative treatment options that are on the horizon. Most of these modalities are promising, and most are non-invasive. Many of these modalities have been used in the general population, where evidence supports their use. The methods have only recently been used for pregnant and postpartum women. Other modalities are specifically for perinatal women but do not have an established track record yet.

 

Methods: This commentary describes some promising approaches to treatment while acknowledging that the literature is preliminary. The goal is to highlight some interesting approaches drawn from a recent comprehensive review of the entire literature on treatment for perinatal mental illness period.

 

Results: Integrative treatments include vitamin D, infant massage, mindfulness-based cognitive therapy, acupuncture, and repetitive transcranial magnetic stimulation (rTMS). Infant massage has been an effective intervention for preterm infants for decades but also helps with maternal mental health. Additionally, ensuring that new mothers are not deficient in vitamin D can reduce the likelihood of depressive symptoms in new mothers likely because correcting the deficiency reduces systemic inflammation. Acupuncture lowered depressive symptoms, made marginal improvements in the brain including changing in gray matter volume, and significantly enhanced resting-state values. Many studies in the general population have found that these integrative treatments are effective, and they also show promise for perinatal women without side effects associated with medications. Some of these treatments can also be adjuncts to what is considered standard care.

 

Integrative treatments three newer medications, brexanolone, zuranolone, and esketamine, quickly and effectively treat severe depression and suicidal ideations. They work on GABA-A and glutamate receptors rather than serotonin or norepinephrine. This represents a shift in depression treatment models.  These medications become less effective after 30 days but can be combined with selective serotonin reuptake inhibitors (SSRIs).

 

Conclusions: Pregnant and postpartum women seeking care for depression and other mental health conditions have many options beyond psychotherapy and SSRI/SNRI antidepressants. These modalities can also be added to their care.

 

Author (s) Details

Kathleen Kendall-Tacket
Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v2/5175