Medicinal drugs are often necessary to re-balance body and soul, but psychopharmacological therapy does not necessarily result in the personal problems of a woman being suppressed. The administration of drugs cannot be avoided with severe depressions and psychoses, but this should only be carried out in close co-operation with a medical specialist (psychiatrist, neurologist). There are now many drugs on the market that can be taken during breastfeeding (for more information see: www.embryotox.de and www.motherisk.org). If a mother wishes to breastfeed her baby, it is recommended she take these drugs as enforced ablactation could, due to feelings of failure and the hormonal change after childbirth, make a depression even worse.
There are different types of psychopharmacological therapies that can be used to treat mental illnesses.
Antidepressants can be classified into three categories: i) tricyclic or tetracyclic antidepressants, ii) selective serotonin re-uptake inhibitor (SSRI), and iii) MAO inhibitors. Antidepressants re-balance neurotransmitters in the brain. Neurotransmitters are chemical messengers in the brain that play a role in in the transfer of information between nerve cells. The noradrenalin and serotonin neurotransmitters appear to be particularly responsible for depressions. The following hast to be observed when taking anti-depressants:
The crucial factor is for the patient to take the drug regularly and according to the doctor's prescription. The drug usually takes 10 or 20 days to take effect. Side effects can be a dry mouth, nausea, constipation, sweating or an increased pulse rate. Everybody reacts differently to a particular drug and the strength of the reactions varies. The unpleasant side effects often disappear after one week. The period of time during which the drug must be taken differs from person to person. Never decide to stop taking the drug yourself! In contrast to sedatives and sleeping agents, antidepressants are not addictive. As soon as the biochemical balance in the body has been re-established, the drugs are no longer necessary.
Anxiety-relieving drugs (tranquilisers)
Anxiety-relieving drugs are also known as tranquilisers (sedatives) or benzodiazepines. Benzodiazepines are the most common group of tranquilisers. They are used to treat anxiety and restlessness, tension in the motor system, irritability and hyperexcitability. In higher doses, benzodiazepines cause tiredness and reduce concentration, but they are usually considered as relatively well tolerated. Tranquilisers should generally be taken only for short periods of time as they can become addictive when taken for long periods.
Anti-manic medication (drugs for bipolar disorders)
If a mother suffers from a mania after the birth of her child, it usually expresses itself in the following ways: elevated mood, low sleep requirement, very rapid rate of speech, manic thinking, distractibility, hyperactivity and a lack of or disturbed judgement.
Manias are principally treated with lithium, neuroleptics, carbamazepin or valproic acid. During treatment with lithium, the lithium level in the blood must be checked carefully as there is the danger of toxicity (overdose). Lithium is a metallic element that in nature only occurs in the form of salt in minerals, mineral water, plant and animal tissue, and also, in a very low concentration, in human tissue. Taking lithium can give rise to considerable side effects that can be avoided by taking small doses spread over the day. The side effects often disappear after a certain amount of time. Lithium is not addictive and is considered a safe method of treatment if the therapy programme is precisely controlled.
As with lithium, the levels of carbamazepin or valproic acid in the blood should also be regularly checked. Originally, carbamazepin and valproic acid are anti-epileptic medications that are used to prevent relapses and stabilise moods in the treatment of bipolar disorders. They are generally used if lithium has not been successful or if it was not tolerated by the patient or if there were other reasons preventing treatment with lithium. Side effects are also likely to occur here, too.
Antipsychotic medication (neuroleptics)
The administration of antipsychotic medication, known as neuroleptics, is necessary if mothers are suffering from psychotic symptoms. Neuroleptics re-establish the biochemical balance in the brain and treat psychotic symptoms such as hallucinations, delirium or mental confusion. The occasionally considerable side effects extend from drowsiness, dry mouth, constipation and dizziness to muscle pains, severe trembling, muscle cramps and a deceleration in physical movement. Additional drugs are often used to reduce these side effects. The physician has to find a correct dosage that both heals the psychotic symptoms and at the same time controls the side effects.
Sleeping agents (hypnotics)
Sleep disorders are a problem for many women suffering from postpartum depression. Any drug with a sleep-inducing or sedative effect can be defined as a sleeping agent or hypnotic, which means that hypnotics (= sleeping agent) cannot be strictly defined as a drugs group. Anxiety-relieving drugs sometime break through the spiralling anxiety that is responsible for sleeplessness in many mothers. Anxiety-relieving drugs such as benzodiazepines can therefore be an effective method against the vicious circle of sleeplessness. Antidepressants can also induce sleep. It should be pointed out that almost all sleeping agents carry the risk of drug addiction.