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PP depression From: Joshua Copel (joshua.copel@yale.edu) Wed Jun 19 13:57:24 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Philip Suarez, M.D.: "Re: I need suggestions as to what to do next" Previous message: gerard.miranda@bcn.servicom.es: "Re: I need suggestions as to what to do next" Subject: Time: 2:51 PM OFFICE MEMO PP depression Date: 6/19/96 >>Lily Kay CNM MS asked : Does anyone know about hormonal treatment for postpartum depression? We have a patient who has just had her second baby, and is depressed again. The first time she had some relief from antidepressants but not completely. Her family situation is very good, and she does not get depressed unless she is post partum. Does anyone do thyroid workup for such a case? If so, which labs specifically?<< The answer for these patients may be estrogen. A patch will do and provides low enough dosing that our old concerns about DVT when we used mega doses for lactation suppression are not an issue (note: I used the past tense for lactation suppression). I would not do a big thyroid or other work-up. See article by Gregoire et al Transdermal oestrogen for treatment of severe postnatal depression. Lancet 1996;347:930-933. For the most severe variety of PP depression, those with fears/fantasies of harming the baby, the psych literature now has suggestions that this may be a variety of obsessive-compulsive disorder, rather than depression. We have a RCT going on here of anti-depressants versus new anti-OCD meds. Don't have a ref, but try a Medline search for N. Epperson. Josh Copel Yale Ob-Gyn, MFM Joshua.Copel@Yale.edu Next message: Philip Suarez, M.D.: "Re: I need suggestions as to what to do next" Previous message: gerard.miranda@bcn.servicom.es: "Re: I need suggestions as to what to do next"

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