Complementary and alternative medicine therapies for perinatal depression

In the paper

“they are best studied as an augmentation treatment [23-25] rather than monotherapy [26].”

What the sources say

• Not checked yetcites [23] Su, 2003, Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial, Eur Neuropsychopharmacol source
• Not checked yetcites [24] Nemets, 2002, Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder, Am J Psychiatry source
• Not checked yetcites [25] Kumar, 1984, A prospective study of emotional disorders in childbearing women, Br J Psychiatry source
• Not checked yetcites [26] Freeman, 2006, Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry, J Clin Psychiatry source

In the paper

“Untreated depression during pregnancy poses risks to the mother and baby, including obstetrical and neonatal complications [3-8].”

What the sources say

• Not checked yetcites [3] Bodnar, 2009, Prepregnancy body mass index, gestational weight gain, and the likelihood of major depressive disorder during pregnancy, J Clin Psychiatry source
• Not checked yetcites [4] Britton, 2011, Infant temperament and maternal anxiety and depressed mood in the early postpartum period, Women Health source
• Not checked yetcites [5] Chung, 2001, Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes, Psychosom Med source
• Not checked yetcites [6] Cripe, 2011, Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy, Paediatr Perinat Epidemiol source
• Not checked yetcites [7] Grote, 2010, A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction, Arch Gen Psychiatry source
• Not checked yetcites [8] Jablensky, 2005, Pregnancy, delivery, and neonatal complications in a population cohort of women with schizophrenia and major affective disorders, Am J Psychiatry source

In the paper

“increased risk of developmental delay and lower IQ scores [12]”

What the sources say

• Not checked yetcites [12] Lindahl, 2005, Prevalence of suicidality during pregnancy and the postpartum, Arch Womens Ment Health source

In the paper

“In a recent UK study, more than a quarter of women reported use of a CAM during pregnancy [14].”

What the sources say

• Not checked yetcites [14] Wu, 2007, Use of complementary and alternative medicine among women with depression: results of a national survey, Psychiatr Serv source

In the paper

“Meta-analyses of randomized controlled trials demonstrate a statistically significant antidepressant benefit of omega-3 fatty acids in mood disorders overall”

What the sources say

• Not checked yetcites [23] Su, 2003, Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial, Eur Neuropsychopharmacol source
• Not checked yetcites [24] Nemets, 2002, Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder, Am J Psychiatry source
• Not checked yetcites [25] Kumar, 1984, A prospective study of emotional disorders in childbearing women, Br J Psychiatry source

In the paper

“In one small prospective observational study women who were (N=33) treated with hypericum while breastfeeding their infants, increased rates of adverse events in infants were reported, such as colic, drowsiness, and lethargy, compared to infants of matched depressed and non-depressed controls [61].”

What the sources say

• Not checked yetcites [61] Lee, 2003, The safety of St John's wort (Hypericum perforatum) during breastfeeding, J Clin Psychiatry source

In the paper

“Limited data in 54 human pregnancies indicated no increased risk of major malformations or prematurity rate for infants born to women taking St. John’s Wort during pregnancy and matched controls [59].”

What the sources say

• Not checked yetcites [59] Moretti, 2009, Evaluating the safety of St. John's Wort in human pregnancy, Reprod Toxicol source

In the paper

“Most, but not all [62], studies demonstrate that bright light therapy is an efficacious, first-line treatment for both seasonal and non-seasonal MDD [63,64].”

What the sources say

• Not checked yetcites [63] Eastman, 1998, Bright light treatment of winter depression: a placebo-controlled trial, Arch Gen Psychiatry source
• Not checked yetcites [64] Golden, 2005, The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence, Am J Psychiatry source

In the paper

“Other studies have provided promising preliminary data regarding feasibility, tolerability, and efficacy in perinatal depression [36,37].”

What the sources say

• Not checked yetcites [36] Freeman, 2006, An open trial of omega-3 fatty acids for depression in pregnancy, Acta Neuropsychiatr source
• Not checked yetcites [37] Kendrick, 2008, A longitudinal study of blood folate levels and depressive symptoms among young women in the Southampton Women's Survey, J Epidemiol Community Health source

In the paper

“There have been no studies published on the efficacy of folate monotherapy or augmentation therapy for perinatal depression.”

In the paper

“several randomized placebo-controlled trials assessing the effectiveness of omega-3 fatty acid supplementation compared to placebo have not demonstrated a benefit in acute treatment or prevention of perinatal depression [31-33].”

What the sources say

• Not checked yetcites [31] Freeman, 2008, Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled study, J Affect Disord source
• Not checked yetcites [32] Doornbos, 2009, Supplementation of a low dose of DHA or DHA+AA does not prevent peripartum depressive symptoms in a small population based sample, Prog Neuropsychopharmacol Biol Psychiatry source
• Not checked yetcites [33] Makrides, 2010, Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial, JAMA source

In the paper

“In a large Danish prospective cohort study of more than 54,000 women, participants who were in the lowest quartile of self-reported fish intake during pregnancy were at increased risk of being treated for depression with an antidepressant up to one-year postnatally [30].”

What the sources say

• Not checked yetcites [30] Rees, 2008, Omega-3 fatty acids as a treatment for perinatal depression: randomized double-blind placebo-controlled trial, Aust N Z J Psychiatry source

In the paper

“There are no studies to date which have evaluated the efficacy of SAMe in antenatal depression.”

In the paper

“In one placebo-controlled study of SAMe for postnatal depressive symptoms, significant decreases in depressive symptoms with SAMe compared to placebo were reported [53].”

What the sources say

• Not checked yetcites [53] Linde, 2005, St John's wort for depression, Cochrane Database Syst Rev

In the paper

“94% of women who received fluoxetine with the addition of folate 500 mcg per day were treatment responders, compared to 61% of those who received fluoxetine and placebo.”

What the sources say

• Not checked yetcites [43] Papakostas, 2012, l-Methylfolate as adjunctive therapy for SSRI-resistant major depression: results of two randomized, double-blind, parallel-sequential trials, Am J Psychiatry source

In the paper

“with one study indicating that adjunctive SAMe improves memory-related cognitive symptoms in depressed patients [52].”

What the sources say

• Not checked yetcites [52] Cerutti, 1993, Psychological distress during the puerperium: a novel therapeutic approach using S-adenosylmethionine, Curr Ther Res source

In the paper

“RCT data that modestly support an antidepressant effect of augmentation with folate (i.e. folic acid 0.4-5mg/day or folinic acid 15-30mg/day)”

In the paper

“Low blood folate has been associated with a poorer response to treatment with antidepressants in MDD [41]”

What the sources say

• Not checked yetcites [41] Alpert, 2003, Prediction of treatment response in geriatric depression from baseline folate level: interaction with an SSRI or a tricyclic antidepressant, J Clin Psychopharmacol source

In the paper

“in a large U.K. prospective cohort study of non-pregnant women, less than 6% of women who became pregnant during the observation period reported daily folic acid supplementation of ≥0.4mg/day [45].”

What the sources say

• Not checked yetcites [45] Grosse, 2007, Folic acid supplementation and neural tube defect recurrence prevention, Birth Defects Res A Clin Mol Teratol source

In the paper

“higher folate levels at baseline appear associated with a better response [42].”

What the sources say

• Not checked yetcites [42] Coppen, 2000, Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial, J Affect Disord source

In the paper

“A small (N=36) randomized, double-blind placebo-controlled trial did find a significant benefit of omega-3 fatty acids compared with placebo in the treatment of antenatal depression [35].”

What the sources say

• Not checked yetcites [35] Freeman, 2006, Randomized dose-ranging pilot trial of omega-3 fatty acids for postpartum depression, Acta Psychiatr Scand source

In the paper

“In studies of seasonal depression, predictors of beneficial response included patients of younger age and with symptoms of hypersomnia and increased eating.”

What the sources say

• Not checked yetcites [63] Eastman, 1998, Bright light treatment of winter depression: a placebo-controlled trial, Arch Gen Psychiatry source
• Not checked yetcites [64] Golden, 2005, The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence, Am J Psychiatry source

In the paper

“the investigators found that fish intake was also strongly associated with sociodemographic characteristics.”

What the sources say

• Not checked yetcites [30] Rees, 2008, Omega-3 fatty acids as a treatment for perinatal depression: randomized double-blind placebo-controlled trial, Aust N Z J Psychiatry source

In the paper

“In five trials of SAMe for cholestasis of pregnancy, there were an absence of adverse events or side effects for mothers or for their infants [50].”

What the sources say

• Not checked yetcites [50] Papakostas, 2010, S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial, Am J Psychiatry source

In the paper

“Safety data based on animal studies are mixed with some studies raising concerns regarding exposure to hypericum and hypercin [56-58].”

What the sources say

• Not checked yetcites [56] Rayburn, 2000, Effect of antenatal exposure to Saint John's wort (Hypericum) on neurobehavior of developing mice, Am J Obstet Gynecol source
• Not checked yetcites [57] Dugoua, 2006, Safety and efficacy of St. John's wort (hypericum) during pregnancy and lactation, Can J Clin Pharmacol
• Not checked yetcites [58] Gregoretti, 2004, Toxicity of Hypericum perforatum (St John's wort) administered during pregnancy and lactation in rats, Toxicol Appl Pharmacol source

In the paper

“Studies investigating the relationship between seafood intake and perinatal depressive symptoms have been mixed, with some demonstrating an inverse relationship between the two [28] and others reporting no such relationship [29].”

What the sources say

• Not checked yetcites [28] Browne, 2006, Fish consumption in pregnancy and omega-3 status after birth are not associated with postnatal depression, J Affect Disord source
• Not checked yetcites [29] Strom, 2009, Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort, Am J Clin Nutr source

In the paper

“Epidemiological data do not demonstrate that higher folate intake during pregnancy mitigates against the development of postnatal depression [47].”

What the sources say

• Not checked yetcites [47] Mischoulon, 2002, Role of S-adenosyl-l-methionine in the treatment of depression: a review of the evidence, Am J Clin Nutr source

In the paper

“More recently, studies assessing adjunctive SAMe with a serotonin reuptake inhibitor have also been positive [51]”

What the sources say

• Not checked yetcites [51] Levkovitz, 2012, Effects of S-adenosylmethionine augmentation of serotonin-reuptake inhibitor antidepressants on cognitive symptoms of major depressive disorder, J Affect Disord source

In the paper

“Two meta-analyses have compared the efficacy of St. John’s Wort to placebo or standard antidepressants in the treatment of depressive symptoms or MDD [54,55].”

What the sources say

• Not checked yetcites [54] Roder, 2004, Meta-analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John's Wort [in German], Fortschr Neurol Psychiatr
• Not checked yetcites [55] Murphy, 2005, Interaction of St John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding, Contraception source

In the paper

“Most, but not all, studies report an association of low folate levels and an increased risk of depression [38-40].”

What the sources say

• Not checked yetcites [38] Watanabe, 2012, Impact of dietary folate intake on depressive symptoms in young women of reproductive age, J Midwifery Womens Health source
• Not checked yetcites [39] Nguyen, 2009, Micronutrient supplementation may reduce symptoms of depression in Guatemalan women, Arch Latinoam Nutr
• Not checked yetcites [40] Papakostas, 2004, Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 1: predictors of clinical response in fluoxetine-resistant depression, J Clin Psychiatry source

In the paper

“Active acupuncture was associated with significantly greater response rates in antenatal depression compared to the control acupuncture or massage groups [95,96]”

What the sources say

• Not checked yetcites [95] Manber, 2004, Acupuncture: a promising treatment for depression during pregnancy, J Affect Disord source
• Not checked yetcites [96] Manber, 2010, Acupuncture for depression during pregnancy: a randomized controlled trial, Obstet Gynecol source

In the paper

“A recent meta-analysis of 30 trials evaluated the efficacy of manual, electrical or laser-based acupuncture vs. sham treatment in men and women with depression found insufficient evidence to recommend the use of acupuncture in the treatment of depression [93].”

What the sources say

• Not checked yetcites [93] Smith, 2010, Acupuncture for depression, Cochrane Database Syst Rev

In the paper

“decreasing urinary levels of cortisol [88]”

What the sources say

• Not checked yetcites [88] Field, 2009, Pregnancy massage reduces prematurity, low birthweight and postpartum depression, Infant Behav Dev source

In the paper

“Three studies that assessed bright light therapy in antenatal depression suggest efficacy.”

What the sources say

• Not checked yetcites [66] Oren, 2002, An open trial of morning light therapy for treatment of antepartum depression, Am J Psychiatry source
• Not checked yetcites [67] Epperson, 2004, Randomized clinical trial of bright light therapy for antepartum depression: preliminary findings, J Clin Psychiatry source
• Not checked yetcites [68] Wirz-Justice, 2011, A randomized, double-blind, placebo-controlled study of light therapy for antepartum depression, J Clin Psychiatry source

In the paper

“Studies of both antenatal aerobic exercise [77] and general physical activity [78] in women without MDD, have shown that exercise or physical activity was associated with fewer depressive symptoms in pregnancy.”

What the sources say

• Not checked yetcites [77] Robledo-Colonia, 2012, Aerobic exercise training during pregnancy reduces depressive symptoms in nulliparous women: a randomised trial, J Physiother source
• Not checked yetcites [78] Da Costa, 2003, Self-reported leisure-time physical activity during pregnancy and relationship to psychological well-being, J Psychosom Obstet Gynaecol source

In the paper

“They did not find that antenatal exercise was associated with a lower prevalence of postnatal depressive symptoms as measured by the EPDS [79].”

What the sources say

• Not checked yetcites [79] Songoygard, 2011, Does exercise during pregnancy prevent postnatal depression? A randomized controlled trial, Acta Obstet Gynecol Scand source

In the paper

“Few controlled studies have evaluated the effectiveness of exercise as a treatment for postnatal depression.”

In the paper

“increasing urinary levels of serotonin and dopamine [86].”

What the sources say

• Not checked yetcites [86] Field, 2004, Massage therapy effects on depressed pregnant women, J Psychosom Obstet Gynaecol source

In the paper

“Two RCTs [95,96] in which pregnant women with MDD were randomized to receive 8 weeks of treatment with active manual acupuncture, control acupuncture, or massage have reported positive results.”

What the sources say

• Not checked yetcites [95] Manber, 2004, Acupuncture: a promising treatment for depression during pregnancy, J Affect Disord source
• Not checked yetcites [96] Manber, 2010, Acupuncture for depression during pregnancy: a randomized controlled trial, Obstet Gynecol source

In the paper

“combining massage therapy with group interpersonal psychotherapy in women with antenatal depression has been shown to reduce depressive symptomatology and cortisol levels greater than group psychotherapy alone [90].”

What the sources say

• Not checked yetcites [90] Field, 2009, Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women, J Bodyw Mov Ther source

In the paper

“and a greater proportion of postnatal women with fully remitted depression [95].”

What the sources say

• Not checked yetcites [95] Manber, 2004, Acupuncture: a promising treatment for depression during pregnancy, J Affect Disord source

In the paper

“Several trials have demonstrated that aerobic exercise reduces depressive symptoms [70,71]”

What the sources say

• Not checked yetcites [70] Krogh, 2010, The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials, J Clin Psychiatry source
• Not checked yetcites [71] Mota-Pereira, 2011, Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder, J Psychiatr Res source

In the paper

“Massage therapy was better tolerated than active manual or control acupuncture.”

What the sources say

• Not checked yetcites [95] Manber, 2004, Acupuncture: a promising treatment for depression during pregnancy, J Affect Disord source
• Not checked yetcites [96] Manber, 2010, Acupuncture for depression during pregnancy: a randomized controlled trial, Obstet Gynecol source

In the paper

“There are few data on the safety or efficacy of perinatal acupuncture.”

In the paper

“Controlled trials evaluating acupuncture as a treatment for MDD have demonstrated inconsistent results regarding efficacy [91,92].”

What the sources say

• Not checked yetcites [91] Quah-Smith, 2013, Laser acupuncture for depression: a randomised double blind controlled trial using low intensity laser intervention, J Affect Disord source
• Not checked yetcites [92] Andreescu, 2011, Acupuncture for the treatment of major depressive disorder: a randomized controlled trial, J Clin Psychiatry source

In the paper

“one study indicated that exercise can reduce physical fatigue in postnatal depressed women [83].”

What the sources say

• Not checked yetcites [83] Dritsa, 2008, Effects of a home-based exercise intervention on fatigue in postpartum depressed women: results of a randomized controlled trial, Ann Behav Med source

In the paper

“Antenatal massage has also been associated with reduced rates of prematurity and low birth weight [88].”

What the sources say

• Not checked yetcites [88] Field, 2009, Pregnancy massage reduces prematurity, low birthweight and postpartum depression, Infant Behav Dev source

In the paper

“Two RCTs comparing a 12-week intervention of exercise to a control situation in postnatal women with an EPDS score of 10 or greater (suggestive of postnatal depression, but in itself not diagnostic) demonstrated significantly greater reduction in EPDS during the study with exercise than the control situation [81,82]”

What the sources say

• Not checked yetcites [81] Heh, 2008, Effectiveness of an exercise support program in reducing the severity of postnatal depression in Taiwanese women, Birth source
• Not checked yetcites [82] Armstrong, 2003, The effects of exercise and social support on mothers reporting depressive symptoms: a pilot randomized controlled trial, Int J Ment Health Nurs source

In the paper

“No studies to date assess exercise for perinatal MDD, although there is a small amount of data for impact upon depressive symptoms in women without MDD.”

In the paper

“Antenatal massage therapy is efficacious in reducing antenatal[86-89] and postnatal [88] depressive symptoms”

What the sources say

• Not checked yetcites [86] Field, 2004, Massage therapy effects on depressed pregnant women, J Psychosom Obstet Gynaecol source
• Not checked yetcites [87] Field, 2008, Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships, J Bodyw Mov Ther source
• Not checked yetcites [88] Field, 2009, Pregnancy massage reduces prematurity, low birthweight and postpartum depression, Infant Behav Dev source
• Not checked yetcites [89] Field, 2012, Yoga and massage therapy reduce prenatal depression and prematurity, J Bodyw Mov Ther source

In the paper

“A recent meta-analysis of 17 RCTs of massage therapy in depressed patients (perinatal studies were excluded) concluded that massage therapy is significantly associated with reduced depressive symptoms [85].”

What the sources say

• Not checked yetcites [85] Hou, 2010, Treatment effects of massage therapy in depressed people: a meta-analysis, J Clin Psychiatry source