Cochrane · systematic review · CD013560
Antidepressant treatment for postnatal depression
Brown, JV, Wilson, CA, Ayre, K, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
37
current version
GRADE rated
22
No studies
15
Included studies
NR
No studies 15 · 40.5%Ungraded 0 · 0%Very low 12 · 32.4%Low 10 · 27%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antidepressants versus placebo for postnatal depression
Population: women of any age, with PND up to 12 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Depression response (acute, 5 ≤ 12 weeks) Antidepressants vs placebo | RR 1.27 [0.97, 1.66] | NR | Low Downgraded: risk of bias, imprecision |
Depression remission (acute, 5 ≤ 12 weeks) Antidepressants vs placebo | RR 1.54 [0.99, 2.41] | NR | Low Downgraded: risk of bias, imprecision |
Adverse events Antidepressants vs placebo | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Depression severity ‐ overall (acute, 5 ≤ 12 weeks) Antidepressants vs placebo | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Depression severity ‐ EPDS (acute, 5 ≤ 12 weeks) Antidepressants vs placebo | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Treatment acceptability ‐ dropouts Antidepressants vs placebo | RR 1.1 [0.74, 1.64] | NR | Low Downgraded: risk of bias, imprecision |
Child‐related outcomes Antidepressants vs placebo | no estimate extracted | NR | No studies |
Antidepressants versus treatment as usual for postnatal depression
Population: women of any age, with PND up to 12 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Depression response or remission (acute, 5 ≤ 12 weeks) Antidepressants vs treatment | no estimate extracted | NR | No studies |
Adverse events Antidepressants vs treatment | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Depression remission (early phase, < 5 weeks) Antidepressants vs treatment | RR 2.31 [1.5, 3.54] | NR | Very low Downgraded: risk of bias, imprecision |
Depression severity ‐ mean EPDS score (early phase, < 5 weeks) Antidepressants vs treatment | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Treatment acceptability ‐ dropouts (early phase, < 5 weeks) Antidepressants vs treatment | RR 1.71 [0.91, 3.23] | NR | Very low Downgraded: risk of bias, imprecision |
Child‐related outcomes Antidepressants vs treatment | no estimate extracted | NR | No studies |
Antidepressants versus psychological interventions for postnatal depression
Population: women of any age, with PND up to 12 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Depression response or remission (acute phase, 5 ≤ 12 weeks) Antidepressants vs psychological interventions | no estimate extracted | NR | No studies |
Adverse events Antidepressants vs psychological interventions | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Depression severity ‐ mean EPDS score (acute phase, 5 ≤ 12 weeks) Antidepressants vs psychological interventions | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Treatment acceptability ‐ dropouts Antidepressants vs psychological interventions | RR 1.07 [0.24, 4.88] | NR | Very low Downgraded: risk of bias, imprecision |
Child‐related outcomes Antidepressants vs psychological interventions | no estimate extracted | NR | No studies |
Antidepressants versus psychosocial interventions for postnatal depression
Population: women of any age, with PND up to 12 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Depression response or remission (acute phase, 5 ≤ 12 weeks) Antidepressants vs psychosocial interventions | no estimate extracted | NR | No studies |
Adverse events Antidepressants vs psychosocial interventions | no estimate extracted | NR | No studies |
Depression severity (acute phase, 5 ≤ 12 weeks) Antidepressants vs psychosocial interventions | no estimate extracted | NR | No studies |
Treatment acceptability ‐ dropouts Antidepressants vs psychosocial interventions | RR 1.94 [1.12, 3.35] | NR | Very low Downgraded: risk of bias, imprecision |
Child‐related outcomes Antidepressants vs psychosocial interventions | no estimate extracted | NR | No studies |
Antidepressants versus any other pharmacological intervention for postnatal depression
Population: women of any age, with PND up to 12 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Depression response (acute phase, 5 ≤ 12 weeks) Antidepressants vs any other pharmacological intervention | RR 0.98 [0.76, 1.27] | NR | Very low Downgraded: risk of bias, imprecision |
Depression remission (acute phase, 5 ≤ 12 weeks) Antidepressants vs any other pharmacological intervention | RR 0.98 [0.68, 1.41] | NR | Very low Downgraded: risk of bias, imprecision |
Adverse events Antidepressants vs any other pharmacological intervention | no estimate extracted | NR | No studies |
Depression response (early phase, < 5 weeks) Antidepressants vs any other pharmacological intervention | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Depression remission (early phase, < 5 weeks) Antidepressants vs any other pharmacological intervention | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Depression severity‐ mean HAM‐D scores (acute phase, 5 ≤ 12 weeks) Antidepressants vs any other pharmacological intervention | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Treatment acceptability ‐dropouts Antidepressants vs any other pharmacological intervention | RR 1.74 [0.99, 3.06] | NR | Very low Downgraded: risk of bias, imprecision |
Child‐related outcomes Antidepressants vs any other pharmacological intervention | no estimate extracted | NR | No studies |
Antidepressants versus any complementary medicine
Population: women of any age, with PND up to 12 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Depression response (acute phase, 5 ≤ 12 weeks) Antidepressants vs any complementary medicine | RR 1.23 [0.71, 2.12] | NR | Very low Downgraded: risk of bias, imprecision |
Depression remission (acute phase, 5 ≤ 12 weeks) Antidepressants vs any complementary medicine | RR 1.17 [0.44, 3.09] | NR | Very low Downgraded: risk of bias, imprecision |
Adverse events Antidepressants vs any complementary medicine | no estimate extracted | NR | No studies |
Depression severity Antidepressants vs any complementary medicine | no estimate extracted | NR | No studies |
Treatment acceptability Antidepressants vs any complementary medicine | no estimate extracted | NR | No studies |
Child‐related outcomes Antidepressants vs any complementary medicine | no estimate extracted | NR | No studies |