Treatment Plan & Prognosis

Treatment Plan

Conservative:

• Watchful waiting
• Psychological interventions

Medical:

• SSRIs: sertraline, paroxetine (first line)
• TCAs: imipramine, nortriptyline
• Can continue antidepressants during pregnancy
• Secondary care advice if unsure

Referral criteria:

• Severe depression
• Significant risk of harm
• Self-neglect
• Possible bipolar disorder
• Severe mental illness
• Postpartum psychosis

PROGNOSIS

• 7x increased risk of postpartum depression if antenatal depression present
• Complications: obstetric issues, SIDS, low birth weight, preterm delivery