Last night I watched the Newsnight programme concerning severe post natal depression and post natal psychosis. These are tragic stories of suicides with harming and even killing the baby and long term treatment with antipsychotics and antidepressants. Regrettably, no mention was made of transdermal oestrogens which have been shown in a good scientific study in the Lancet from my team to be very effective even in patients who have not responded to antidepressants. (Gregoire et al 1996).
We also heard the extraordinary statement that women with a history of bipolar disorder had a one in two chance of developing post natal depression. That is true but what is omitted is that many of these young women who allegedly have bipolar disorder really have severe premenstrual depression and that the same hormonal fluctuations which produce the premenstrual symptoms also produce the post natal tragedies. In my view premenstrual depression, post natal depression and even menopausal depression are essentially endocrine problems which are best and most effectively treated with hormones. No doubt antidepressants are sometimes also necessary and the treatment by oestrogens should not exclude any necessary treatment with antidepressants.
The evidence is clear from published work but it is difficult nay impossible for psychiatrists to accept the use of the more logical and more effective use of transdermal oestrogens for severe post natal depression.
Gregoire AJ, Kumar R, Everitt B, Henderson AF, Studd HW, Lancet 1996 Apr 6:347(9006):930-3
22nd August 2012