Which of the following medications would most likely be used in the management of postpartum depression?

 

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Correct

- Sertraline

- Aripiprazole

- Clozapine

- Paliperidone

Rationale

Sertraline is correct because this is an SSRI (selective serotonin reuptake inhibitor), a first choice antidepressant commonly used in the treatment of postpartum depression. This drug DOES pass into breastmilk, but no immediate effects have been observed in breast fed infants whose mothers take Sertraline. Because postpartum depression can be so debilitating for affected mothers, it is important for providers to understand how to recognize and treat this condition. Some providers also prescribe hormone replacement therapy in addition to an antidepressant.
Aripiprazole (Abilify) is incorrect because this drug is an anti-psychotic commonly given for schizophrenia and bi-polar disorder, not postpartum depression. Additionally, this medication is excreted in breastmilk, and it is likely the postpartum mother is breastfeeding. It is important to note that the main difference between an antipsychotic and antidepressant is that an antidepressant uplifts a person's mood, whereas antipsychotics control episodes of psychosis in which there are hallucinations and delusions.
Clozapine is incorrect because this drug is an anti-psychotic, commonly given for schizophrenia.
Paliperidone is incorrect because this is an anti-psychotic drug, not an antidepressant. This drug passes into breastmilk and has a potential for serious effects on an infant exposed to breastmilk containing this drug.

References:
Postpartum Depression - Medications. (n.d.). Retrieved March 21, 2018, from https://www.webmd.com/depression/postpartum-depression/tc/postpartum-depression-medications

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