Updated guidelines for pharmacologic treatment of perinatal depression: Understanding medication options

The 2023 American College of Obstetricians and Gynecologists (ACOG) guideline on perinatal mental health conditions recommends prescribing and titrating pharmacotherapy for perinatal depression, with the selective serotonin reuptake inhibitors sertraline and escitalopram as first-line medications for patients who have not previously taken any medications for mood disorders. A subsequent ACOG Clinical Practice Update addresses zuranolone for postpartum depression. The authors present an overview of the guideline's recommendations on pharmacotherapy for treating perinatal depression and summarize actionable recommendations for nonpsychiatric clinicians.