Medication Options for Postpartum Depression
Postpartum depression medication is an important part of treating PPD. Medications prescribed by licensed healthcare providers help reduce and manage symptoms for people who may be suffering from this depressive disorder.
Understanding PPD Medications
Postpartum depression medication is used to alter the brain’s neurotransmitters. Neurotransmitters are chemicals in the brain that communicate various emotions, moods, and behavioral functions.
By taking postpartum depression medication, the mother’s anxiety, sadness, and irritability can decrease. Other symptoms like fatigue, loss of energy, and loss of appetite can also improve over time.
A physician or psychiatrist must prescribe postpartum depression medication. Different medications can be prescribed over a specific time as determined by your doctor or mental health professional. Most postpartum depression medications are taken daily. It normally takes one to four weeks before you notice their effects.
Overview of Postpartum Depression
Understanding what PPD is (and isn’t) helps to understand the medications that might be needed to treat postpartum depression. Simply put, postpartum depression is a mood disorder that affects roughly 15% of women during their first year of pregnancy.
Due to the hormonal changes that occur during and after pregnancy, depression is common amongst women and new mothers. Depression during and after pregnancy is known as “perinatal depression,” whereas depression that occurs after giving birth and lasts more than two or three weeks is known as “postnatal depression” or PPD.
Women experience a sudden drop in estrogen and progesterone within the first few days after the baby is born, resulting in mood swings and symptoms of depression. This short, common phase of depression is often called the “baby blues” and usually lasts for a few weeks.
However, if depression symptoms worsen, last longer than a few weeks, or include other symptoms, the Office of Women’s Health recommends talking with your doctor to receive screening for postpartum depression. Your doctor may also run blood tests to eliminate any additional issues, such as problems with your thyroid.
What Causes PPD?
There is no specific cause of postpartum depression. However, certain factors can increase a woman’s risk of developing PPD. A family history of depression or a diagnosed mental illness can be a key risk factor for developing PPD.
Other difficult circumstances surrounding the pregnancy or birth can also potentially lend towards causing PPD. Traumatic birth experiences, difficult pregnancies, and children born with special needs may increase the risk of PPD. Stressful life events such as job loss or a friends or family member’s death can also contribute to the development of PPD.
Types of Postpartum Depression Medication
There are different types of medications that can be taken for postpartum depression. The type of medication prescribed largely depends on the set of symptoms and the specific type of postpartum depression someone is suffering from.
Depending on the severity of the condition, clinicians may prescribe two or more types of medications to be taken together. In these cases, the postpartum depression medications work on different symptoms. Most symptoms can be managed by taking several medications together, often alongside some form of psychotherapy (such as Cognitive Behavioral Therapy or Interpersonal Therapy).
As of 2019, the medication Brexanolone (Zulresso®) was approved by the US Food and Drug Administration (FDA) specifically for treating postpartum depression. Brexanolone is a fast-acting one-time infusion, bringing almost instant relief to new mothers suffering from postpartum depression.
“Postpartum suicide is the second-leading cause of maternal postpartum mortality. I think [Brexanolone] is going to be very helpful for high-risk, severely depressed moms.”
—Maria Muzik, M.D. | Associate Professor of Psychiatry and Obstetrics & Gynecology at Michigan Medicine
The following are the other common medications that may be prescribed to treat symptoms of postpartum depression.
Antidepressants are the most commonly prescribed medication for postpartum depression. Most antidepressant medications are called Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are thought to improve the brain’s ability to produce and absorb serotonin more effectively. Serotonin is a natural neurotransmitter. It communicates mood, emotion, and behavior messages throughout the brain.
When serotonin production and absorption improve, so does the person’s mood. SSRIs effectively treat PPD symptoms like chronic sadness, irritability, and anxiety.
Another form of antidepressant is the Serotonin Norepinephrine Reuptake Inhibitor (SNRIs), which works the same way as an SSRI but includes norepinephrine. Norepinephrine is a neurotransmitter responsible for mobilizing the brain and body into action. Other antidepressants include tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs).
Some common antidepressant medications prescribed during the postpartum period include:
- Bupropion (Wellbutrin®, Zyban®)
- Escitalopram (Lexapro®)
- Venlafaxine (Effexor®)
- Fluoxetine (Prozac®, Sarafem®)
- Paroxetine (Paxil®, Pexeva®)
- Sertraline (Zoloft®)
In cases of severe postpartum depression, another drug type called antipsychotics can be prescribed. These drugs address obsessive and compulsive thoughts, actions, hallucinations, and delusions. Antipsychotic medications are also used to help reduce extreme mood swings. For this reason, antipsychotic drugs can aid women struggling with postpartum OCD or postpartum psychosis, which cause severe symptoms.
Physicians may prescribe antipsychotic medications with SSRIs to treat all the symptoms of extreme postpartum depression disorders.
Some common antipsychotics that may be prescribed to treat more severe postpartum depression are:
- Haloperidol (Haldol Decanoate®)
- Chlorpromazine (Thorazine®, Largactil®)
- Olanzapine (Zyprexa®)
- Quetiapine (Seroquel®)
- Risperidone (Risperdal®)
Benefits of Postpartum Depression Medications
Postpartum depression medications can offer many benefits for women suffering from debilitating depression and anxiety symptoms.
Here are some of the benefits of postpartum depression medications.
Near-Immediate Symptom Relief
For women suffering from postpartum depression, relief can’t come soon enough. Thankfully, a course of postpartum depression medications can begin to take effect and relieve symptoms in one to four weeks. Antidepressants start working at different rates in each person, so some may experience relief even sooner.
Medication for Short-Term Treatment
Many women take antidepressants to treat postpartum depression because they know it provides short-term relief. Because postpartum depression eventually heals, there’s no need to permanently take medications to treat it.
You may find that taking medication for postpartum depression will be helpful for the first 6-12 months. You can stop taking them once you’ve fully recovered.
Availability of Options
Because there are many different postpartum depression medications, there are plenty of options to suit each person’s needs. If you experience negative side effects or no improvement on one medication, your doctor can identify a better option.
Concerns About Postpartum Depression Medications
While postpartum depression medications such as antidepressants are prescribed safely and controlled, some women may be concerned about how the medication will affect them while breastfeeding.
SSRIs, in particular, are considered safe to take during breastfeeding and should not affect or harm the baby. Other types of medications may have an effect on breast milk. You should address any concerns with your doctor if you have questions about breastfeeding while taking postpartum depression medications.
Other concerns may arise about the possible side effects of taking medication for postpartum depression. For example, while Brexanolone (Zulresso®) is considered effective, it also carries the risk of causing excessive sedation.
Postpartum depression medications such as antidepressants or antipsychotics are prescribed as a course of treatment and therefore cannot be stopped abruptly. To prevent any possible negative side effects, you should speak to your doctor before you stop taking prescription medications.
Complementary Treatment Options for Medication for PPD
Medication is an effective treatment method for postpartum depression, but additional care can benefit new mothers dealing with PPD.
Therapy is a common treatment option and is often recommended alongside medication treatment. Psychiatry not only helps women work through the emotional and mental struggles they experience during PPD but can also provide many benefits through follow-up sessions after the postpartum period has ended.
Holistic methods such as meditation and mindfulness can also decrease some symptoms of PPD. There are even numerous apps (many of which are free) to help women learn to meditate or practice breathwork if they are unfamiliar with these practices.
Clinical trials show that social support can be immensely helpful during postpartum, even as simple as phone calls or emails from loved ones checking in and saying hi. To take it a step further, support groups can offer women with PPD a safe, understanding environment to discuss their PPD journey.
In rare cases, treatment of postpartum depression may call for more extreme therapies. Doctors may recommend Electroconvulsive Therapy (ECT), or “electroshock therapy,” for women struggling with postpartum psychosis and have a high success rate with minimal to no complications.