Promising leads and pitfalls: a review of dietary supplements and hormone treatments to prevent postpartum blues and pos
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REVIEW ARTICLE
Promising leads and pitfalls: a review of dietary supplements and hormone treatments to prevent postpartum blues and postpartum depression Yekta Dowlati 1,2 & Jeffrey H. Meyer 1,2 Received: 4 June 2020 / Accepted: 3 November 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Prevention of postpartum depression (PPD) is important because it typically has a 13% prevalence rate, impactful immediate symptoms with greater risk of suicide, and higher long-term risk of psychiatric symptoms in both the mother and family. There are no universal approaches across all childbearing women that have proven to be preventative for PPD, so it is hoped that dietary and/or hormonal interventions will be developed. There are some effective preventative approaches for PPD, such as psychotherapy and medical management, for the highest risk cases, like when there is a past history of a major depressive episode. The purpose is to review studies that assess dietary and hormonal interventions for prevention of PPD and/or postpartum blues, a high-risk state for PPD. Studies that assess dietary and hormonal interventions for prevention of PPD which included a comparison group were reviewed, including omega-3 fatty acids, mineral and vitamin supplements, amino acid combinations, allopregnanolone, progesterone, and thyroxine. Presently, development of dietary supplements and hormonal products for prevention of PPD is at an early stage with most trials showing results that are either preliminary, not definitive, trend level or variable across studies. Even so, a few directions are not recommended for further investigation such as progesterone and thyroxine. On the other hand, studies of allopregnanolone for prophylaxis of PPD are needed. Also, given the number of trend level findings and the multifactorial etiology of PPD, it may be prudent to investigate combined interventions rather than monotherapies. There is still a major need to develop a dietary supplement that creates resiliency against the biological changes in early postpartum associated with risk for mood disorders and/or PPD. Keywords Postpartum depression . Natural health products . Prevention . Dietary supplements
Introduction Postpartum depression (PPD), defined as a clinical level major depressive episode (MDE) starting within the first year after giving birth, is highly impactful. PPD is the most common complication of childbearing with a typical prevalence rate of 13% (Steiner 1998; O’Hara 2009; O’Hara and Swain 1996). In addition to the immediate symptoms of an MDE, the risk of suicide is heightened more than 10-fold (Comtois et al. 2008). Furthermore, an episode of PPD may last for * Jeffrey H. Meyer [email protected] 1
Department of Psychiatry, University of Toronto, Toronto, Canada
2
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
years (Horowitz and Goodman 2004; Goodman 2004), and history of PPD is associated with recurrence
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