This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers’ compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers’ compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.
|Journal||International Journal of Environmental Research and Public Health|
|Publication status||Published - 10 Feb 2022|
Bibliographical noteFunding Information:
Acknowledgments: We are grateful to all national members of Riseup-PPD COST ACTION and the researchers and clinicians that supported our search for clinical practice guidelines. This paper is based upon work from the COST Action Riseup-PPD CA 18138 and was supported by COST under COST Action Riseup-PPD CA18138 www.cost.eu (access date 30 September 2021).
Funding: This paper was supported by COST under COST Action Riseup-PPD CA18138 www.cost.eu (access date 30 September 2021). A.L. was supported by the Norwegian Research Council (grant number 288696). C.A.W. was funded by the UK’s National Institute for Health Research (NIHR). The funders had no role in the analyses, interpretation of results, or the writing of this manuscript.
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