Treatments for postnatal depression assessed

Giving antidepressants to women with postnatal depression early in the course of the illness is likely to result in the greatest improvement in symptoms, according to new research from the University of Bristol, funded by the National Institute for Health Research, Health Technology Assessment (HIHR HTA) programme.

Postnatal depression is a substantial public health problem affecting around 10 per cent of new mothers. It can lead to long-term serious consequences for mother, baby, family, friends and colleagues. Despite its frequency and potential long-term consequences, only about 50 per cent of cases of postnatal depression are detected by health professionals. However, like other forms of depression, if detected, postnatal depression is easily treatable.

The study, led by Professor Deborah Sharp from Bristol’s School of Social and Community Medicine, compared the effectiveness and cost-effectiveness of antidepressant drug therapy with a community-based psychosocial intervention.  A total of 254 women were recruited from 77 general practices in England to receive either an antidepressant prescribed by their GP or counselling (listening visits) from a specially trained research health visitor (HV).

The results show that in the population studied where the prevalence of postnatal depression was just under 10 per cent, antidepressants were significantly superior to general supportive care at four weeks.  There was a lack of evidence for a significant difference between antidepressant therapy and listening visits at 18 weeks as the trial design allowed women to switch groups, or add the alternative intervention at any time after four weeks.

Professor Sharp said: “Although many women, at least initially, revealed a preference for listening visits, it would appear that starting women on antidepressants early in the course of illness is likely to result in the greatest improvement in symptoms.  There is an urgent need for GPs and HVs to agree the care pathway for women who suffer from postnatal depression, not only for the benefit of the mother, but also the child.”

The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme commissions research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS.  It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 550 issues published to date.