雌激素和孕激素
一项关于雌孕激素预防和治疗产后抑郁症的Cochrane综述中指出,可在产后期极谨慎地使用合成孕激素,雌激素治疗可能具有一定价值。[76]Dennis CL, Ross LE, Herxheimer A. Oestrogens and progestins for preventing and treating postpartum depression. Cochrane Database Syst Rev. 2008;(4):CD001690.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001690.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/18843619?tool=bestpractice.com然而,雌激素的使用没有经过严格的评估,考虑到使用该激素与血栓栓塞风险升高相关,进一步的研究是必要的。苏格兰校际指南网络(SIGN)不推荐在产后抑郁症的治疗中常规使用雌激素。[41]Scottish Intercollegiate Guidelines Network. Management of perinatal mood disorders. March 2012. http://www.sign.ac.uk (last accessed 21 October 2016).http://www.sign.ac.uk/pdf/sign127.pdf
n-3脂肪酸:碳烯酸(EPA)和二十二碳六烯酸(DHA)
关于EPA和DHA预防及治疗围产期抑郁的[77]Miller BJ, Murray L, Beckmann MM, et al. Dietary supplements for preventing postnatal depression. Cochrane Database Syst Rev. 2013;(10):CD009104.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009104.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/24158923?tool=bestpractice.com疗效的数据尚无定论。[78]Ng RC, Hirata CK, Yeung W, et al. Pharmacologic treatment for postpartum depression: a systematic review. Pharmacotherapy. 2010;30:928-941.http://www.ncbi.nlm.nih.gov/pubmed/20795848?tool=bestpractice.com[79]Jans LA, Giltay EJ, Van der Does AJ, et al. The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression. Br J Nutr. 2010;104:1577-1585.http://www.ncbi.nlm.nih.gov/pubmed/21078211?tool=bestpractice.com