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Medications for Treating Postpartum Depression (PPD)

Postpartum depression treatment
Written by:

Rabia Khaliq

MSc in Applied Psychology

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Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.Read more
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.

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 10-15% of mothers worldwide [1*] , and different treatments have been discovered to help overcome it.

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.

Connect with our healthcare professionals online to receive personalized help in overcoming depression.

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 linked to the development of PPD [2*] . This improves a person’s mood and energy levels, making it easier for them to perform necessary duties in daily life and engage in other therapeutic activities, such as counseling or support groups.

Symptoms of postpartum depression

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:

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 two placebo-controlled clinical studies [6*] .

Zulresso is exclusively accessible through the Zulresso REMS Program [7*] , which means you can receive it only from a medical professional practicing in an accredited healthcare facility. The treatment process is closely supervised because Zulresso has potential serious side effects, such as sudden loss of consciousness and excessive sedation. Patients may also be recommended to monitor oxygen levels in the blood. All the warnings and precautions should be discussed with a healthcare provider.

Zurzuvae (Zuranolone)

In 2023, the FDA approved [8*] the new postpartum depression medication that can be taken orally—Zurzuvae (zuranolone). It is a neurosteroid antidepressant that targets specific receptors in the brain that regulate mood, cognition, behavior, and arousal. The typical dosage for Zurzuvae [9*] is 50 mg taken once daily for 14 days, preferably in the evening after consuming a fatty meal, but it can be changed if necessary.

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, potentially contributing [10*] to the onset of postpartum depression.

The American Journal of Psychiatry published a recent study that showed how the medication effectively reduced symptoms of depression [11*] in just 15 days compared to a placebo group. The study’s earliest assessment was on day three, and improvements were observed throughout the drug evaluation and follow-up period, which lasted until day 42.

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.

Take the first step today: reach out to a healthcare provider for an online consultation and learn more about postpartum depression medications.

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.

Discussing medicine for postpartum depression

Sexual dysfunction is a typical adverse effect of SSRI [12*] antidepressant medications, and the risk of having this reaction increases with the increased dosage. According to the FDA, both Lexapro and Zoloft can induce erectile dysfunction in men (delayed ejaculation, decreased libido, and impotence). It may also cause decreased libido in women. If you experience any sexual side effects while taking either Lexapro or Zoloft, inform your healthcare provider.

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.

Talk to a licensed healthcare professional to learn what treatment approach can help you best.

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.

Frequently Asked Questions

Zulresso (intravenous (IV) infusion) and Zurzuvae (oral medication) are approved by the FDA specifically to treat postpartum depression. Other medications like antidepressants are also used for this condition off-label. It’s essential to consult a healthcare professional to choose the option that will be most suitable for your particular case.
The duration of treatment usually depends on the specific medication, the patient’s response to it, the intensity of symptoms, and other factors. It’s typically recommended to continue treatment for several months or longer after symptom relief, but the exact period can be determined only by a healthcare professional.
Given that anxiety and depression frequently co-occur, medicine for postpartum depression and anxiety may also be chosen from SSRI or SNRI classes. Your healthcare professional will choose the best medication for you based on your symptoms and needs.
An OB-GYN (obstetrician-gynecologist) can prescribe medication for depression, including postpartum depression. Being experts in women’s reproductive health, with a focus on issues related to pregnancy and childbirth, they can identify the causes of perinatal mood disorders like PPD and suggest treatment. However, if more specialized treatment is required, they may refer you to a psychiatrist or mental health professional.

Sources

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+12 sources
  1. Prevalence of postpartum depression and interventions utilized for its management
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  2. Pathophysiological Mechanisms Implicated in Postpartum Depression
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  3. Selective Serotonin Reuptake Inhibitors
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  4. Tricyclic Antidepressants
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  5. Bupropion (Wellbutrin)
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  6. FDA approves first treatment for post-partum depression
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  7. Risk Evaluation and Mitigation Strategy (REMS) Document ZULRESSO (brexanolone) REMS Program
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  8. FDA Approves First Oral Treatment for Postpartum Depression
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  9. Zurzuvae (zuranolone)
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  10. Allopregnanolone in Postpartum Depression
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  11. Zuranolone for the Treatment of Postpartum Depression
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  12. Pharmacogenetics of SSRIs and Sexual Dysfunction
    Source link
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Written by:

Rabia Khaliq

MSc in Applied Psychology
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This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.