Which medication is indicated for perinatal depression postpartum?

Sertraline is a selective serotonin reuptake inhibitor (SSRI) that is commonly prescribed for the treatment of depression, including perinatal depression postpartum. Its efficacy and safety profile make it a preferred choice among healthcare providers for breastfeeding mothers, as it has been well-studied in this population. Sertraline also has a favorable side effect profile, making it suitable for patients who may be particularly sensitive during the postpartum period.

Other medications listed, such as nortriptyline, phenelzine, and fluoxetine, may also be used in the treatment of depression, but they are generally not the first-line treatments for postpartum depression. Nortriptyline, a tricyclic antidepressant, can be less favored due to its side effects and the need for monitoring. Phenelzine, a monoamine oxidase inhibitor (MAOI), is rarely used in modern practice due to potential contraindications with many foods and medications. Fluoxetine is another SSRI that is effective but may have a longer half-life, which can lead to prolonged side effects in some individuals, making sertraline a more attractive option post-delivery.