For those with postpartum depression, there are several medication and treatment options, including new prescription medications and medications under investigation. This article will explore the best medication options for postpartum depression, including new developments and considerations for treatment.
Understanding Postpartum Depression (PPD)
Postpartum depression is a condition that affects women who have just given birth or adopted a child into their family. It can manifest with symptoms of depression but modified based on motherhood like:
- Feeling guilty for taking time for self-care
- Feeling worthless as a mother
- Feeling sad nearly every day
- Feeling irritable
- Not interested in activities you once enjoyed
- Not enjoying your new baby
- Crying for no reason
- Having trouble making decisions
- Experiencing low energy
- Feeling like you are a ‘terrible’ mother
- Having headaches or upset stomachs for no reason
- Problems with sleeping or eating too much or too little
- Having frightening thoughts about harm to yourself or to your new baby
It is important to note that postpartum depression is a clinical condition that differs from baby blues. Baby blues are something experienced by 80% of new mothers within the first few days of giving birth. These symptoms often resolve within one week on their own.
But postpartum depression is when symptoms last for several weeks or months after birth, and they are severe enough to interfere with carrying out daily activities as a new mother.
Best Medication for Postpartum Depression: An Overview
So, what is the best medication for postpartum depression?
Antidepressants
The standard medication prescribed for depression, including postpartum depression, is antidepressants, like SSRIs. Under normal circumstances, your brain produces a certain amount of serotonin, and then it reabsorbs it to keep your mood level and happy. If your body doesn’t produce enough, or it gets absorbed too quickly, it can raise depression levels.
SSRIs can slow the reabsorption of serotonin so that your mood remains elevated.
Hormonal Therapy
Hormonal therapy can also be prescribed for postpartum depression. During pregnancy, women experience a substantial change in hormones. After giving birth, there is a big drop in hormones, and this can exacerbate the feelings of depression. Hormonal therapy can help counter this drop, making it gradual instead.
New Medications for Postpartum Depression
You can also explore new medications for postpartum depression, such as Spravato and Zulresso.
Brexanolone (Zulresso)
Zulresso is an IV treatment for PPD which is administered over the span of several days. It works through the central nervous system.
Esketamine (Spravato)
Spravato is an FDA-approved hallucinogenic drug used to treat postpartum depression. It comes in a nasal spray or IV treatment and can help relieve symptoms within an hour.
Zuranolone (Under Investigation)
This is a pill that is a form of allopregnanolone. This helps regulate the mood by changing certain substances in the brain. It is taken as a pill over several weeks.
Choosing the Best Medication for Postpartum Depression
When looking at new postpartum depression medication, you have to consider several factors.
Factors to Consider When Choosing a Treatment
One of the most important factors is the timeline. If you are experiencing suicidal thoughts or thoughts of harm, then you need to consider a fast-acting solution like Spravato, which can take effect immediately.
Another important factor is the side effects. If you are breastfeeding, you need to consider which new postpartum depression medication might get into the breast milk. Other side effects might render you temporarily unable to care for your child, in which case you will need to work with your family and/or doctor to ensure there is support at home.
Working with Your Healthcare Provider
Working with your healthcare provider is essential, especially if you want postpartum depression medication like Esketamine, which can only be administered by an approved clinic. Your healthcare provider can review which medications are covered by your insurance, the timeline for them to take effect, and any side effects.
Managing Side Effects and Monitoring Progress
Managing side effects and monitoring progress are key aspects of any treatment plan and that requires working with your healthcare provider.
Common Side Effects to Be Aware Of
Each medication has unique side effects.
- Zuranolone, for example, will pass into the breastmilk, and studies are not sure whether it causes harm to the baby. Other side effects can include drowsiness, diarrhea, and fatigue.
- Zulresso can cause drowsiness, skin flushing, and thoughts of harm.
- Spravato can cause nausea, dizziness, irritation in the nose (if administered via nasal spray), and, in more serious cases, thoughts of suicide.
Regular Monitoring and Follow-Up
Regular monitoring and follow-up appointments are essential for anyone taking new postpartum depression medication. Some new medications for postpartum depression can cause severe side effects in rare cases, and regular monitoring will ensure any severe complications are safely addressed.
When to Seek Help for Postpartum Depression
It is important to recognize the signs of postpartum depression. As mentioned, almost all new mothers experience baby blues immediately after giving birth, owing to the drop in hormones. However, if the signs of depression continue for weeks and they do not resolve on their own or, in fact, get worse, it might be time to talk to your doctor.
Risk Factors
There are certain risk factors that increase the chances of developing postpartum depression. If you notice the following, reach out to a doctor:
- You have had depression in the past
- You have taken medication for depression before pregnancy
- You have experienced violence or abuse
- You have limited support from family, friends, or community
- You have inadequate housing, employment, education, or income
- You have recently undergone a stressful life event
- You had a complicated pregnancy or birth
If you are at a higher risk or recognize the signs in yourself or a loved one, it is important to talk to a doctor.
How to Talk to Your Doctor
Many women are reluctant to talk to a doctor about medication because they are ashamed of the problem and worried about being considered a bad mother. Others have been discouraged by their families or think that their symptoms should be effectively managed on their own.
None of this is true. It is important to reach out to a doctor immediately, knowing that you will not be judged but instead helped.
Conclusion
As a new mother, it is important to seek help early and consult with your healthcare provider. Doing so will help you find the best medication for postpartum depression based on individual needs.