There is no doubt that certain psychiatric disorders—including depression, anxiety disorders, eating disorders, and psychoses—can make pregnancy and the postpartum period a less-than-joyful time for some women. In the March BCMJ, Part 1 of this theme issue on reproductive mental health described the challenge of identifying common psychiatric disorders experienced by pregnant [9] and postpartum [10] women. Part 1 also discussed the work of the British Columbia Reproductive Mental Health program based at BC Women’s Hospital and St. Paul’s Hospital. This flagship provincial program provides inpatient and outpatient psychiatric care as well as education and outreach services.

This second part of the theme issue focuses on treatment options for pregnant, postpartum, and lactating patients experiencing psychiatric disorders. The first article describes different kinds of antipsychotic medicines that might be used to relieve symptoms and stabilize mood [11], while the second article discusses the use of antidepressant medications [12], particularly selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). The third article describes some nonpharmacological treatments that have proved effective for patients with mild or moderate symptoms [13]. These treatments have also proved to be useful additions to a medication-based treatment plan for patients with severe symptoms.

—Shaila Misri, MD, FRCPC
Clinical Professor, Psychiatry and Obstetrics and Gynaecology,
University of British Columbia
Medical Director, Reproductive Mental Health, BC Women’s Hospital and St. Paul’s Hospital