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Antidepressant treatment for postpartum depression may be overprescribed

NOMIS Awardee Janet Currie and postdoctoral research associate Esmée Zwiers have published a study in the National Bureau of Economic Research (NBER) suggesting that antidepressants may be overprescribed for treating postpartum depression.

In countries like the U.S. and the Netherlands, antidepressants are a commonly prescribed treatment for postpartum depression. But a new study by Princeton University scholars suggests that prescribing rates in some areas of the Netherlands are too high.

Janet Currie

This usage is connected to several negative outcomes: mothers are less likely to return to work, they are less likely to live with the father of their child, and they are more likely to birth second child within 30 months following the first. They are also more likely to develop and be treated for other severe psychiatric disorders.

However, selection into antidepressant treatment might be skewing these correlations. For example, one might expect that the most severely ill women would most likely be prescribed antidepressants and would have worse future outcomes. To account for this, the researchers focused their study on women who were more likely to receive antidepressants because they lived in areas with high-prescribing doctors.

They found that postpartum patients on antidepressants were consistently more likely to rely on them up to three years after giving birth, but that there was little effect on other outcomes. They also found that low-income and socially disadvantaged mothers were more likely to live in high-prescribing areas.

The evidence points to an overprescription of antidepressants in certain regions, the researchers report in a working paper published by the National Bureau of Economic Research.

“Treatment with antidepressant drugs has been described as the ‘mainstay’ of treatment for postpartum depression, but most studies have had small or unrepresentative samples,” said co-author Janet M. Currie, the Henry Putnam Professor of Economics and Public Affairs and co-director of Princeton University’s Center for Health and Wellbeing (CHW). “By using a large and representative sample and focusing on a range of outcomes important to women’s well-being, we hope to fill some of the gaps in the past literature.”

Continue reading this Princeton University story

Read the NBER publication: Medication of Postpartum Depression and Maternal Outcomes: Evidence from Geographic Variation in Dutch Prescribing

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Henry Putnam Professor of Economics and Public Affairs
Princeton University
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