Depression which interferes with maternal role functioning occurs in 10 to 15% of women following birth. This disorder causes personal and family suffering at a time when adaptation to the tasks of parenthood is critical. Women who have suffered devastating postpartum major depression fear repeating the experience after subsequent births, but there are no controlled studies regarding prevention of recurrent episodes.
Specific Aims : A. The purpose of this study is to conduct a double-blind, randomized clinical trial of the efficacy of the antidepressant nortriptyline in the prevention of recurrent postpartum major depression. The preventive efficacy of nortriptyline will be compared to placebo during the first 20 weeks postpartum in 96 subjects. The hypotheses are: (1) the rate of occurrence of PPMD will be less in the nortriptyline-treated women compared to the placebo-treated women, and (2) of women who become depressed, the time to recurrence will be longer in the nortriptyline- treated women compared to the placebo-treated women. B. These mothers will be followed for the remaining 32 weeks of the first postpartum year. The goals for this naturalistic follow-up period are: (l) to evaluate the adequacy of the length of treatment (20 weeks) in the clinical trial, and (2) to determine if the rate of and time to recurrence after the clinical trial differs among women who took nortriptyline compared to women who took placebo. C. To identify prospectively the clinical predictors of recurrence during the clinical trial.
| Moses-Kolko, Eydie L; Price, Julie C; Wisner, Katherine L et al. (2012) Postpartum and depression status are associated with lower [[¹¹C]raclopride BP(ND) in reproductive-age women. Neuropsychopharmacology 37:1422-32 |
| Okun, Michele L; Luther, Jim; Prather, Aric A et al. (2011) Changes in sleep quality, but not hormones predict time to postpartum depression recurrence. J Affect Disord 130:378-84 |
| Hanusa, Barbara H; Scholle, Sarah Hudson; Haskett, Roger F et al. (2008) Screening for depression in the postpartum period: a comparison of three instruments. J Womens Health (Larchmt) 17:585-96 |
| Moses-Kolko, Eydie L; Wisner, Katherine L; Price, Julie C et al. (2008) Serotonin 1A receptor reductions in postpartum depression: a positron emission tomography study. Fertil Steril 89:685-92 |
| Peindl, Kathleen S; Wisner, Katherine L; Hanusa, Barbara H (2004) Identifying depression in the first postpartum year: guidelines for office-based screening and referral. J Affect Disord 80:37-44 |
| Epperson, C Neill; Terman, Michael; Terman, Jiuan Su et al. (2004) Randomized clinical trial of bright light therapy for antepartum depression: preliminary findings. J Clin Psychiatry 65:421-5 |
| Wisner, Katherine L; Hanusa, Barbara H; Peindl, Kathleen S et al. (2004) Prevention of postpartum episodes in women with bipolar disorder. Biol Psychiatry 56:592-6 |
| Peindl, Kathleen S; Wisner, Katherine L (2003) Successful recruitment strategies for women in postpartum mental health trials. J Psychiatr Res 37:117-25 |
| Oren, Dan A; Wisner, Katherine L; Spinelli, Margaret et al. (2002) An open trial of morning light therapy for treatment of antepartum depression. Am J Psychiatry 159:666-9 |
| Wisner, K L; Perel, J M; Blumer, J (1998) Serum sertraline and N-desmethylsertraline levels in breast-feeding mother-infant pairs. Am J Psychiatry 155:690-2 |
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