Post partum

and indirectly may help depression. Biofeed- before taking any new prescription or nonpre- back, like relaxation therapies, should be done only in addition to psychotherapy and medi- Exercise as appropriate for you physical condi- Massage Therapy: Massage therapy may help tion in the days right after giving birth. lower stress, but it does not cure depression. Participate in activities with your significant Relaxation Therapies: Learning special relaxa- Talk to your family and friends. tion methods can help with depression, along with medicines and psychotherapy. Yoga and Develop a regular sleep and nap pattern. Learn ways to lower stress, such as breathing Art and Music Therapies: Some women find art and music therapy, along with medicines and psychotherapy, are helpful in treating postpar- Do not try to overcome postpartum depres- sion by yourself. Seek professional help if you believe that you or a loved one has the symp- In most cases postpartum depression slowly goes away in the first 9 months after birth. For a few women it lasts beyond 1 year. Treatment Get emergency care if you or a loved one has serious thoughts of suicide or harming your What can I do to help myself or my loved one? baby, or if you hear voices or see things not present, or have delusions (thoughts not Maintaining a healthy lifestyle is crucial. Staying physically and socially active, especially with your significant other, is very important. Hav- ing regular sleep and eating patterns will also help you. Since you will need to be up during the night with your baby during the first few months, it is important to take naps to keep Information contained in this booklet is meant for
Certain medicines such as reserpine, benzodi- informational purposes only and should not substitute
azepines, digitalis, and possibly beta-adrenergic the visit to your doctor nor his/her advice for your
health care.

blockers can add to the symptoms of depres- sion. It is important to check with your doctor Accuracy of the content is current to the date of
W h a t i s P o s t P a r t u m D e p r e s s i o n ? Feeling sad or blue shortly after the birth monoamine oxidase inhibitors (MAOs), anti- of a baby is very common. For most women Have low sexual desire and function. depressants, selective serotonin reuptake in- these postpartum blues are mild and go away hibitors (SSRIs), tricyclic antidepressants such within a week. However, for 10 to 20% of Have trouble concentrating or remem- women, especially very young mothers, the de- Feel hopeless or just do not care about pression is more severe and lasts longer. Have unexplained pain in your back or You must take antidepressant medicines daily Worry that you will ever feel better. for 3 to 6 weeks to get full benefit from them. You may have postpartum depression within a There are no nonprescription medicines avail- few days to a few weeks after giving birth or hav- Some women also become anxious, have halluci- ing a miscarriage. For about 60% of women, it is nations, or delusions. If you have hallucinations your first episode of depression. While hormone (hear voices or see things not present) or delu- changes after giving birth seem to play a part, the sions (thoughts not grounded in reality) this is full causes are not known. Risk factors that in- Seeing a psychologist, psychiatrist, or psycho- crease your chances of getting postpartum de- therapist is helpful with postpartum depres-sion. Therapy may last a short time or may need to go on for many months. Cognitive Behavioral Therapy (CBT) is a form of psy- having been depressed sometime before you got pregnant Your doctor can tell you if your symptoms are chotherapy that is especially helpful. CBT is a having been depressed after a previous pregnancy postpartum depression. He or she will ask about way to help you identify and change thought having family members who were depressed, especially after your symptoms and any drug or alcohol use. You processes that lead to depression. Replacing may be tested to rule out medical problems such returning home with your baby to a very stressful home or negative thoughts with more positive ones as hormone imbalances. There are no lab tests to having a baby with health problems or a baby who cries having a miscarriage late in pregnancy or a stillbirth If your pregnancy was unwanted you are also at risk for post Claims have been made that certain herbal and dietary products help depression. St. Do not try to overcome postpartum depression John's wort is the only one that research by yourself. It can be successfully treated with ei- shows is effective in treating postpartum de- ther psychotherapy or antidepressant medicine or pression. Check with your doctor before be- both. Discuss this with your doctor or therapist. ginning St. John's wort if you are breast- Besides feeling sad and uninterested in activities, Many types of alternative treatments may help Several types of medicines can help treat postpar- Feel unable or unwilling to care for your baby. tum depression. Discuss the use of medicines with Biofeedback: Through biofeedback you learn your doctor if you are breast-feeding. Your doc- to control body functions such as muscle ten- Have trouble falling asleep, wake up very early, or sleep too tor will carefully select a medicine for you. Some sion or brain wave patterns. Biofeedback can Have little or excessive appetite. help with tension, anxiety, and concentration,


5. Prescription sous DCI et substitution INTRODUCTIon La prescription sous dénomination commune internationale (DCI) et la substitution font depuis de nombreuses années l’objet de divergences entre médecins généralistes, pharmaciens et autorités. De plus, la récente modification de la législation a probablement augmenté la confusion. La prescription sous DCI permet néanmoins de

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