Becoming a new parent is a beautiful experience but it can come with unexpected challenges. Aside from lack of sleep and change in routines, there might be emotional difficulties and mental health conditions, such as postpartum depression. This condition affects
This article delves deep into the range of medications prescribed for depression during the postpartum period. Read on to know which ones may be suitable in this case, when medicines are necessary or non-essential, and how to support the effects of pharmacological treatment.
Understanding Postpartum Depression
You may have heard of the “baby blues,” which are feelings of sadness or mood swings that can occur within a few days of giving birth. However, in some people, it may become more intense and prolonged, transforming into postpartum depression (PPD).
PPD can affect anyone regardless of their gender. Research shows that one in eight new mothers and one in ten men have postpartum depression. Women tend to experience the peak of this condition around months two to three. The symptoms include crying, feelings of guilt and hopelessness, and losing interest in most activities. On the other hand, men usually encounter peak symptoms later in the first year and exhibit more anger and risky behaviors instead of melancholy.
When Is Medication Necessary?
For mild to moderate postpartum depression, psychotherapy is usually the first-line treatment. However, if the symptoms are severe and pose a risk to the parent’s or child’s well-being, therapy, and lifestyle changes might not be enough. In this case, medications may be necessary. They can be prescribed for a limited time to relieve the acute phase of depression or for the long term.
Medicines help fix the imbalances of serotonin and dopamine
Types of Medications for Postpartum Depression
The most common medications used for postpartum depression are antidepressants belonging to different classes. They are the primary treatment for major depressive disorder but can be effective for other related conditions. Examples include:
- Selective serotonin reuptake inhibitors (SSRIs). SSRIs like fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) are typically the first-line choice for PPD. They
increase serotonin levels [3*] in the brain, which helps reduce depressive symptoms. - Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs affect both serotonin and norepinephrine levels in the brain. Examples include venlafaxine (Effexor) and duloxetine (Cymbalta).
- Tricyclic antidepressants (TCAs). These medications also
affect the levels of serotonin and norepinephrine [4*] . They are less selective compared to SSRIs and SNRIs, which increases the risks for side effects, but they may be more suitable for some people. Examples include nortriptyline (Pamelor) and amitriptyline (Elavil). - Atypical antidepressants. These medications primarily affect dopamine. They are often used when other antidepressants aren’t effective or when sexual side effects are a concern. Examples include mirtazapine (Remeron) and bupropion (
Wellbutrin [5*] ).
FDA-Approved Medications for Postpartum Depression Treatment
PPD is usually treated with medications initially indicated for major depressive disorder and other mental health conditions. So, the common medications for postpartum depression listed above are prescribed off-label. However, there are two medications approved by the Food and Drug Administration (FDA) specifically for PPD.
Zulresso (Brexanolone)
The FDA approved Zulresso (brexanolone) for postpartum depression in adults in March 2019. It is used as an intravenous (IV) infusion with effects lasting for 60 hours (equivalent to 2.5 days). The effectiveness of this medication was confirmed through
Zulresso is exclusively accessible through the
Zurzuvae (Zuranolone)
In 2023, the
Zulresso and Zurzuvae are both derived from allopregnanolone, a neurologically active steroid that is a byproduct of the hormone progesterone. Its levels can significantly increase during pregnancy and then sharply decline after childbirth,
The American Journal of Psychiatry published a recent study that showed how the medication
Note: The choice of the medicine for postpartum depression and its dosage depends on the individual’s symptoms, medical history, and potential side effects. It is essential to work closely with a healthcare professional to determine the most suitable treatment plan for managing postpartum depression.
Taking Medication for Postpartum Depression While Breastfeeding
Certain antidepressant medications are considered safe for use during breastfeeding. The levels of medication in breast milk and therefore the infant’s exposure to it depend on the medication type, dosage, dosing frequency, breastfeeding frequency, and other factors. When a baby is premature or has health issues, the decision to breastfeed while taking medication requires extra consideration.
It’s essential to keep in touch with your healthcare provider to weigh all the potential benefits and risks appropriately, monitor the dynamics of treatment, and make adjustments if needed.
Sexual dysfunction is
Can You Overcome Postpartum Depression Without Medication?
It is possible to treat postpartum depression with the help of non-medication approaches if symptoms are mild to moderate. However, it’s also a common practice to use them alongside medication to improve the effects. Examples include:
- Psychotherapy. Talk therapy provides a safe space to discuss feelings, learn coping strategies, and address the emotional challenges associated with childbirth. Typically used approaches are cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
- Support groups. Such groups allow mothers to discuss similar concerns and learn more about maternal mental health. Sharing experiences with others who understand what you’re going through can provide emotional relief and practical advice.
- Social support. Reach out to friends, family, or a babysitter for support. Having a solid support system can make a significant difference in your recovery.
- Self-care. Even though it can be challenging to pay enough attention to your own sleep and nutrition during the first months, it’s important to care about yourself to be able to care about the baby. Try to set aside some time for yourself, be it for a nap, a walk, or any other activity, and avoid excessive stressors.
Mindfulness and relaxation techniques. Practicing mindfulness, meditation, or relaxation exercises can help manage stress and anxiety.
In Conclusion
If you are experiencing depressive symptoms, it is essential to consult a healthcare professional. After a thorough review of your health history, they will determine the most suitable treatment options and create a personalized plan to help you get more positive emotions from parenting.
In the case of severe postpartum depression, pharmacological treatment may be required. Medications prescribed for postpartum depression have been researched well, and you can discuss all the available options and their pros and cons with your healthcare provider. Remember, seeking help is a sign of strength, and with the right guidance and treatment, you can improve your well-being regardless of current challenges.
