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围产期抑郁症的快速起效治疗方法:临床概况与未来展望

Rapid-Acting Treatments for Perinatal Depression: Clinical Landscapes and Future Horizons.

作者信息

Beydler Emily M, Koire Amanda, Steuber Elizabeth, Taylor Joseph J, Mergler Reid J

机构信息

Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.

Penn Center for Women's Behavioral Wellness, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

Int J Environ Res Public Health. 2025 Apr 2;22(4):546. doi: 10.3390/ijerph22040546.

Abstract

Perinatal depression affects approximately 1 in 5 women and is the leading cause of maternal mortality in the United States. In addition to evidence-based treatment with antidepressant medications, there has been a push to identify rapid-acting options for pregnant and postpartum individuals. This paper reviews the evidence behind new pharmacological agents (neurosteroids and ketamine) and non-pharmacological approaches (transcranial magnetic stimulation). The paper also highlights the risks and benefits of electroconvulsive therapy and selective serotonin reuptake inhibitors. Based on recent studies and research, the paper provides considerations when prescribing these modalities including: timing of symptom onset, severity of presentation, breastfeeding priorities, prior treatment response and treatment availability and cost.

摘要

围产期抑郁症影响着约五分之一的女性,是美国孕产妇死亡的主要原因。除了使用抗抑郁药物进行循证治疗外,人们一直在努力为孕妇和产后女性寻找快速起效的治疗方案。本文综述了新型药物制剂(神经甾体和氯胺酮)及非药物治疗方法(经颅磁刺激)背后的证据。本文还强调了电休克疗法和选择性5-羟色胺再摄取抑制剂的风险和益处。基于近期的研究,本文在开具这些治疗方式时提供了一些考虑因素,包括:症状出现的时间、表现的严重程度、母乳喂养的优先级、既往治疗反应以及治疗的可及性和成本。

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本文引用的文献

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Prevalence of Community Perinatal Psychiatrists in the US.美国社区围产期精神科医生的患病率。
JAMA Netw Open. 2024 Aug 1;7(8):e2426465. doi: 10.1001/jamanetworkopen.2024.26465.
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Pharmacogenomic Clinical Support Tools for the Treatment of Depression.治疗抑郁症的药物基因组学临床支持工具。
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