The article you requested is
Primary Care Companion J Clin Psychiatry 2001;3:86-89
© Copyright 2014 Physicians Postgraduate Press, Inc.
Background: Women who have suffered one episode of postpartum-
onset major depression (PPMD) comprise a high-ris
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 high.