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 www.mansoormedical.org printing.
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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