There is a great unmet need for harmonized, up-to-date clinical practice guidelines for the treatment of peripartum depression. The absence of guidelines in many countries and the discrepancy in recommendations may lead to inequalities in management. Gisèle Apter, MD, PhD, Groupe Hospitalier du Havre, Université de Rouen Normandie, Rouen, France, discusses current and emerging treatment options for peripartum depression. Often, the decision to initiate pharmacological intervention is based on maternal disease severity, as well as available resources. Currently, there are no pharmacotherapeutic options in Europe specific for peripartum depression and thus, cases are typically approached as is depression outside of the peripartum period. Selective Serotonin Reuptake Inhibitors (SSRIs) are the most used antidepressants during pregnancy and in the first year postpartum. Breastfeeding is a key consideration, as this can impact the agent chosen. Decision making in the setting of pregnancy and lactation can be complex, as it involves weighing up the possible risk of exposure against the adverse effects of sub-optimally treated depression, for both mother and child. Prof. Apter highlights allopregnanolone as a very promising treatment option currently under investigation that is thought to act within days and only require short-term use. This interview took place at the 35th European College of Neuropsychopharmacology (ECNP) Congress 2022 in Vienna, Austria.
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Prof. Apter reports the following disclosures: Biogen and Sage Therapeutics consulting board.