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Reader Remarks on:

Joint APA-ACOG Algorithms for Treatment of Depression During Pregnancy

• Depression during pregnancy
• A response from JW Associate Editor Deborah Cowley
• Depression During Pregnancy
• Psychotherapy during the first trimester

Depression during pregnancy

Jack Friedman, private clinic, 29 Sep 2009 1:54 PM EST

Competing interests: None declared

There have been recent studies showing positive effects of exercise programs in postpartum depression. Is this included in your protocols?

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A response from JW Associate Editor Deborah Cowley

Deborah Cowley, MD, Professor, Dept of Psychiatry & Behavioral Sciences, Univ of Washington School of Medicine, Seattle, 29 Sep 2009 6:30 PM EST

Competing interests: Summary Author

Thank you for your comment. This work group was focused on developing evidence-based algorithms for treatment during pregnancy, not for postpartum depression. They did not include exercise in their algorithms. Because exercise has been shown to be beneficial for depression, it would certainly be worth recommending to women who are pregnant and postpartum, as appropriate given their medical condition.

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Depression During Pregnancy

Reed Schimmelfing, MSW, LICSW, 29 Dec 2009 6:17 PM EST

Competing interests: Bright light therapy practitioner, owner, New Light Solutions

It is understandable but unfortunate that such a limited scope of options were assessed in this work. The reader would be better served if the summary at least mentioned additional options that have been shown to be helpful without the medication risks such as exercise (as raised by the earlier response), bright light therapy, vitamin D, etc.

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Psychotherapy during the first trimester

Violet A. Henighan, 8 Feb 2010 12:58 PM EST

Competing interests: None declared

In the wake of Paxil's lost lawsuit and the findings of birth defects, wouldn't it be wise to help the patient with intense psychotherapy during the first trimester?

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Your Remark: