CONTEXT: Postpartum depression (PPD) is a frequent complication of childbirth, with complexities in its clinical management. OBJECTIVE: In this review article, we propose clinical questions which are relevant to the pharmacological treatment of PPD. METHOD: Searches were performed in MEDLINE, PsychInfo, CINAHL, Biological Abstracts, Lilacs and in the Cochrane Central Register of Controlled Trials. RESULTS: Current treatment guidelines for the treatment of depression apply to women with PPD which are not breastfeeding. Significant antidepressant levels are more often detected in children exposed to fluoxetine or citalopram. In those who are exposed, untoward effects and reduced growth are possible. CONCLUSIONS: Until the impact of antidepressant exposure through breastfeeding is better understood, a possible clinical approach would be to prescribe antidepressants generally not detected in the infants' plasma, such as sertraline or paroxetine.
Postpartum depression; drug therapy; selective serotonin reuptake inhibitors; breast feeding; child development