Pregnancy and postpartum antidepressant use moderates the effects of sleep on depression.

Abstract

This study examined the course of antidepressant use, sleep quality, and depression severity from pregnancy through 6-month postpartum in women with and without a depressive disorder during pregnancy. Women (N = 215) were interviewed during pregnancy, 1- and 6-month postpartum. Mixed linear models were used to examine the longitudinal course and inter-relationships for the time-varying variables of antidepressant use, subjective sleep quality, and depression severity. Pregnant women with a depressive disorder who did not use antidepressants had more variable depression severity over time with improvements in depression severity by 6-month postpartum. In contrast, the depression severity of their medicated counterparts remained stable and high throughout. Pregnant women without a depressive disorder had worse sleep quality when using antidepressants compared with when they were not. Antidepressant use significantly strengthened the magnitude of the effect of sleep quality on depression severity in women with a depressive disorder during pregnancy. When prenatally depressed women use antidepressants, their sleep disturbance is more highly linked to depression severity than when they do not. Furthermore, antidepressants are not adequately treating the sleep disturbance of these women or their remitted counterparts, leaving both groups vulnerable to significant negative mental and physical health outcomes.

• Authors: Kristen C Stone, Amy L Salisbury, Cynthia L Miller-Loncar, Jennifer A Mattera, Cynthia L Battle, Dawn M Johnsen, Kevin E O'Grady
• Journal: Archives of women's mental health (Arch Womens Ment Health) Vol. 20 Issue 5 Pg. 621-632 (10 2017) ISSN: 1435-1102 [Electronic] Austria
• PMID: 28488099 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Antidepressive Agents
• Serotonin Uptake Inhibitors

Topics

• Adult
• Antidepressive Agents (administration & dosage, adverse effects)
• Depression, Postpartum (drug therapy)
• Female
• Humans
• Postpartum Period
• Pregnancy
• Pregnancy Complications (drug therapy, therapy)
• Pregnant Women (psychology)
• Prospective Studies
• Selective Serotonin Reuptake Inhibitors (administration & dosage, adverse effects)
• Severity of Illness Index
• Sleep (drug effects)
• Sleep Wake Disorders (physiopathology)
• Treatment Outcome