Postpartum Depression: New Possible Treatment Options
Whether it’s dismissed as “baby blues” or seriously acknowledged by medical professionals as a syndrome in need of scientific study and treatment, postpartum depression is a life-altering series of symptoms experienced by many new mothers in the months following labor and delivery. Postpartum depression, or PPD, is very common, ranging from approximately 11-25% in the first year, but this figure is a conservative underestimate. Many women who experience some degree of PPD cannot or do not seek help, even if their symptoms are severe.
Postpartum depression manifests itself in several relevant ways. PPD sufferers can experience fatigue, emotional numbness, sadness, a persistent sense of guilt, or anger that can turn to rage. Left untreated, PPD can obviously have long-lasting repercussions. It may interfere with the parent-child bonding that needs to occur for healthy child development. In its extreme form, PPD may be the cause of self-harm, parental neglect, suicide, or harm to others.
Causes of Postpartum
Elevated levels of the primary female hormones estrogen and progesterone are normal during pregnancy, but they drop dramatically immediately following delivery. Whereas some women are not sensitive to this sharp change in blood chemistry, others definitely are. Part of the problem researchers and physicians have experienced in treating PPD has been the fact that this hormonal shift differentiates postpartum depression from “normal” depression. Although antidepressants such as selective serotonin reuptake inhibitors, or SSRIs, can provide some relief for women’s postpartum symptoms, they often take weeks to manifest any effects. These weeks are obviously crucial to postnatal recovery and parent-child bonding, to say nothing of the urgent importance of being able to meet the fundamental needs of a newborn.
A further issue in developing PPD treatment is that researchers do not fully understand all of the causes of postpartum depression, particularly since some patients experience some PPD symptoms while others do not. PPD may be partially triggered by a neurotransmitter known as GABAA, but as new parents know, the stress of caring for a newborn can have serious physical and psychological effects as well. Financial and marital stresses coupled with fatigue may also play a role.
Researchers have been aiming at a PPD-specific treatment for at least five years, specifically focusing on a neurosteroid called brexanolone, developed by Sage Therapeutics. Brexanolone is designed to target those brain chemicals specific to PPD. Though further testing is obviously needed, initial small-scale trials appear to have demonstrated effective results. Researchers hope that eventual treatments for postpartum depression can cut back the time in which drug therapy manifests positive effects. Ideally, researchers hope, instead of waiting the weeks or months it takes SSRIs to begin showing results, patients may experience positive effects within days. Further clinical trials will help demonstrate the short- and long-term efficacy of brexanolone.
Currently, brexanolone has been given phase 1 and phase 2 clinical trials. The most prominent side effects of patients on brexanolone therapy included some degree of dizziness and fatigue. Although Sage Therapeutics intends to file for a new application in 2018 with the Food and Drug Administration, the results from brexanolone’s phase 3 clinical trials have not yet been published for peer-review assessment in a professional journal. Peer reviews of the methods and outcomes of brexanolone’s trials will obviously be key to its wider acceptance and use as a treatment for postpartum depression, as researchers can examine and analyze the clinical trials to verify and test this course of treatment. Meanwhile, researchers, physicians, and patients continue to hope that an effective treatment for postpartum depression will be available to patients soon.
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