Miller D Claire, Chawla Devika, Johansen Taber Katherine, Payne Jennifer L, Del Tredici Andria L
Department of Research and Development, Myriad Genetics, Inc, Salt Lake City, UT, USA.
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
BMC Psychiatry. 2025 Jun 4;25(1):572. doi: 10.1186/s12888-025-06977-z.
Pharmacotherapy is one modality recommended to treat postpartum depression (PPD), but treatment patterns are not well characterized. In this study we characterized psychiatric medications used to treat PPD in real-world settings.
Two cohorts of patients diagnosed with PPD within 180 days of delivery between October 2015 and January 2022 were retrospectively studied using two U.S. claims databases (Symphony Health [SH], Myriad Genetics-Komodo Health [MGKH]). Prescription fills of select psychiatric medications in the 365 days after PPD diagnosis were assessed using pharmacy claims.
The two cohorts (SH, MGKH) included 124,742 and 22,141 patients with PPD, respectively. Most patients with PPD (SH: 64.9%, MGKH: 76.4%) filled at least 1 prescription in the year following diagnosis; of those, 76.4% and 62.7%, respectively, discontinued treatment at least once. Medication changes were also common among treated patients, with 16.6% in SH and 18.3% in MGKH filling 3 or more unique psychiatric medications. In each cohort, selective serotonin reuptake inhibitors (SSRIs) comprised 72.2% of observed first-line treatments following PPD diagnosis, and sertraline was the most common first-line SSRI (39.4% and 41.4% of first-line treatments, respectively). Later-line therapies were not dominated by any single medication or medication class.
While the majority of patients with PPD were prescribed pharmacotherapy, treatment patterns were heterogeneous and characterized by frequent discontinuation and medication switching. These results suggest that first-line treatments may fail, and that some patients may need multiple medication trials to improve symptoms.
Not applicable.
药物治疗是推荐用于治疗产后抑郁症（PPD）的一种方式，但治疗模式尚未得到充分描述。在本研究中，我们描述了在现实环境中用于治疗PPD的精神科药物。
使用两个美国索赔数据库（Symphony Health [SH]、Myriad Genetics-Komodo Health [MGKH]）对2015年10月至2022年1月期间在分娩后180天内被诊断为PPD的两组患者进行回顾性研究。使用药房索赔评估PPD诊断后365天内选定精神科药物的处方配药情况。
两组（SH、MGKH）分别包括124,742例和22,141例PPD患者。大多数PPD患者（SH：64.9%，MGKH：76.4%）在诊断后的一年内至少开具了1张处方；其中，分别有76.4%和62.7%的患者至少停药一次。药物更换在接受治疗的患者中也很常见，SH组中有16.6%，MGKH组中有18.3%的患者开具了3种或更多独特的精神科药物。在每个队列中，选择性5-羟色胺再摄取抑制剂（SSRI）在PPD诊断后的观察到的一线治疗中占72.2%，舍曲林是最常见的一线SSRI（分别占一线治疗的39.4%和41.4%）。二线治疗并不以任何单一药物或药物类别为主。
虽然大多数PPD患者接受了药物治疗，但治疗模式是异质性的，其特点是频繁停药和换药。这些结果表明一线治疗可能无效，一些患者可能需要多次药物试验来改善症状。
不适用。
