Prevention of Recurrent Postpartum Depression: A Randomized Clinical Trial
J Clin Psychiatry 2001;62(2):82-86
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Women who have suffered one
episode of postpartum-onset major depression (PPMD) comprise a
high-risk group for subsequent episodes. We conducted a
double-blind, randomized clinical trial to test the efficacy of
nortriptyline in the prevention of recurrent PPMD.
Method: Nondepressed women who had at least one
past episode of PPMD (Research Diagnostic Criteria) were
recruited during pregnancy. Subjects were randomly assigned to
nortriptyline or placebo. Treatment began immediately postpartum.
Each subject was assessed for 20 sequential weeks with the
Hamilton Rating Scale for Depression and Research Diagnostic
Criteria for recurrence of major depression.
Results: No difference was found in the rate of
recurrence in women treated with nortriptyline compared with
those treated with placebo. Of 26 subjects who took nortriptyline
preventively, 6 (0.23, 95% exact confidence interval [CI] = 0.09
to 0.44) suffered recurrences. Of 25 subjects who took placebo, 6
(0.24, 95% exact CI = 0.09 to 0.45) suffered recurrence (Fisher
exact p = 1.00).
Conclusion: Nortriptyline did not confer
additional preventive efficacy beyond that of placebo. The rate
of recurrence of PPMD (one fourth of women) was unacceptably