Major Depressive Disorder (MDD) impacts the emotional attachment between pregnant women and fetuses during the postpartum period. MDD exposes pregnant women to sleep disturbances, anhedonia, hopelessness and decreased energy. However, prescribing FDA-approved, nonpharmacological, and off-label drugs can reduce the severity of MDD among pregnant women. I recommend the use of fluoxetine for the treatment of MDD because the FDA-approved drug increases the amount of serotonin in the brain. On the one hand, fluoxetine helps women in pregnancy to have a balanced mental health status and immunity to obsessive-compulsive disorder (Muraro et al., 2019). On the other hand, the FDA-approved medicine causes heartburn, dry mouth, anxiety, insomnia, appetite loss, stuffy nose, and uncontrollable shivering.
Alternatively, amitriptyline off-label drug and cognitive behavioral therapy (CBT) nonpharmacological intervention can be applied in treating major depressive disorder. Amitriptyline improves mood and increases energy levels during pregnancy, while CBT raises the rational thought processes and self-esteem among affected individuals (Chen & Shan, 2019). Although the off-label drug aids the treatment of MDD, amitriptyline has health side effects like diarrhea, sexual dysfunction, constipation, and severe headaches (Urits et al., 2019). Amitriptyline also increases suicidal thoughts if used for long-term treatment of depression.
The decision-making regarding the treatment of clients with MDD, especially pregnant women, requires assessing primary risk factors. In this case, family history, past medical information, and personal traits would impact the choices for treatment. However, psychomotor agitation, fatigue, reduced concentration, weight loss, inappropriate guilt, and depressed moods inform doctors on the frameworks of MDD treatment. MDD has clinical practice guidelines that govern its diagnosis and treatment. The DSM-5 criteria for MDD suggest that clients can be diagnosed with the disorder if they exhibit more than 5 symptoms within two weeks of monitoring (Chen & Shan, 2019). Depressed moods, change of pleasure, and previous functioning guarantee the diagnosis of MDD.
References
Chen, C., & Shan, W. (2019). Pharmacological and nonpharmacological treatments for major depressive disorder in adults: A systematic review and network meta-analysis.Psychiatry Research, 281(5), 112-595.
Muraro, C., Dalla Tiezza, M., Pavan, C., Ribaudo, G., Zagotto, G., & Orian, L. (2019). Major depressive disorder and oxidative stress: In Silico investigation of fluoxetine activity against ROS.Applied Sciences, 9(17), 3631. Web.
Urits, I., Peck, J., Orhurhu, M. S., Wolf, J., Patel, R., Orhurhu, V., Kaye, A. D., & Viswanath, O. (2019). Off-label antidepressant use for treatment and management of chronic pain: Evolving understanding and comprehensive review.Current Pain and Headache Reports, 23(9), 37-47. Web.