New Treatment for Postpartum Depression

New Treatment for Postpartum Depression 

It is estimated that postpartum depression affects 1 in 8 women in the US per year. Before now, a fast-acting or affordable medication has not been available to treat this debilitating and serious condition

Many new mothers experience what is described as the “baby blues” which can include moodiness, crying spells, anxiousness, irritability, feeling overwhelmed, and problems sleep and appetite. These symptoms  which appear to be related to hormonal changes in a new mother, usually last for several weeks to months, and resolve without professional help. 

However, sometimes these symptoms linger, or become more severe, leading to what is called Postpartum Depression (PPD), which can present as an inability to care for the infant, a difficulty in handling daily activities, and in some cases, even suicide. 

Mothers may experience a difficulty bonding with their baby, or becoming withdrawn from family and friends, experiencing a loss of energy and constant tiredness, loss of interest or pleasure in activities previously enjoyed, severe anger, feelings of worthlessness, fears of not being a good mother to their infant, impaired ability to think clearly or make  decisions easily, panic attacks, thoughts of self harm or harm of the baby.  

In very severe cases, a condition known as Postpartum Psychosis may develop in which hallucinations and delusions, along with paranoid feelings, feelings of being lost and confused, and suicide or harm to their baby. This condition requires immediate treatment.

A new medication pill called Zuranolone (Zurzuvae) has recently been approved by the FDA for the short term treatment of PPD. The good news is that it can be taken in pill form, rather than the previously used IV infusion which has been very costly. Improvement in PPD symptoms is reported to occur within 3 days, which is in sharp contrast to most antidepressants used today that usually take up to two weeks before a change occurs, and 4-8 weeks before a full effect is seen.

Zuranolone is a metabolite of progesterone, a naturally occurring hormone in the body which rises dramatically during pregnancy, and drops dramatically after childbirth. Zuranolone is usually taken once a night for 14 days, and the benefits are reported to last for up to 4 weeks after stopping the medication. Side effects may include drowsiness, dizziness, diarrhea, fatigue, upper respiratory and  urinary tract infections. 

Of course, the decision to take this medication needs to discussed with your primary physician or psychiatrist, and many not be appropriate foe everyone.

Zuranolone, like most medications prescribed for behavioral health conditions, is not a cure-all, and it is best to combine use of this medication with other treatment modalities including psychotherapy, behavioral interventions, support groups.

Women with a previous history of depression, or who have Bipolar Disorder, are at increased risk for developing PPD. 

All new mothers should be screened for this condition.

Let me know your thoughts or experience with this problem

Robert A. Lowenstein MD

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