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Upon entering the hospital, Antrim’s life was circumscribed by encounters with therapists and a regime of heavy medications — “Trazodone, Ativan, Seroquel, nortriptyline, and chloral hydrate.”

Among the non-counseling treatments, four studies used pharmacological or dietary treatments for perinatal depression, including sertraline, nortriptyline, and omega-3 fatty acid treatments, but these also yielded mixed and inconclusive results.

The second group received physical therapy along with prescription pain medicines, either gabapentin or nortriptyline – conservative treatment.

Tricyclic drugs including clomipramine, nortriptyline and doxepin were effective in the lab against types of brain, blood and skin cancers, Prof Pilkington says.

Usually we start with lifestyle changes including diet, and if this does not succeed, we move on to preventive medications such as nortriptyline, verapamil or topiramate.