Update on the treatment of depression during pregnancy

Approximately one in four women will experience depressive symptoms during pregnancy. Untreated depression is associated with diminished prenatal care and can adversely affect the course of pregnancy, the developing fetus and birth outcomes. There is a pressing need therefore for safe, well tolerated, efficacious treatments. Risk–benefit decisions are best made on an individual case basis by an informed patient in consultation with her family and healthcare provider(s). Illness severity, course of illness, stage of pregnancy and patient preferences shape the decision-making process. This review summarizes recent literature on the course and impact of major depression and dysthymia during pregnancy, as well as providing an update on treatment strategies including complementary/alternative medicine, psychoeducation, psychotherapy and pharmacotherapy.