A new treatment for postpartum depression is out! Learn about it now!
A teary 22-year-old comes into my office 3 weeks after the delivery of her first baby. She is tired, stressed and anxious. She doesn't know what to do and I want women to understand that I see this every day and it is pretty common but it is not normal if it doesn’t get better. So let's understand what you should know about your feelings after you give birth and what you can do to improve your symptoms.
So there is a difference between postpartum blues and postpartum depression. Those "baby blues" usually happen around 2-3 days after delivery and you may have feelings of crying for no particular reason, question yourself about every little thing and have trouble with sleeping even though you are exhausted. These symptoms usually get better within the first two weeks once you and your baby get to know each other, have a little more of a "schedule" and start figuring each other out.
Now if these feelings are lasting longer and you start having a more intense feeling of depression or anxiety that doesn't allow you to do your daily activities, this is more consistent with postpartum depression. This can occur up to 1 year after delivery and usually starts within the first month. The main causes of postpartum depression include hormonal changes and can be more common if you have a history of depression or anxiety prior to pregnancy. Other risk factors include stressful life changes during pregnancy or the early postpartum period, a traumatic birth experience if your baby was born with a health issue or needed a NICU stay, not enough support from significant other or family members and of course breastfeeding problems.
If you are concerned you could be experiencing these symptoms or your family members are concerned about you, please see your doctor before your scheduled postpartum visit if necessary. This is one of the main reasons there will be a change in the common 6 week postpartum visit so patients can be seen earlier to get the help you need sooner.
Treatment options include therapy sessions and/or sometimes antidepressants. If your doctor and yourself find that you need medication, remember that if you are breastfeeding the amount of medication that gets into the milk is very low and if medication is necessary to keep you a happy mama, then the benefits outweigh the risks. If you had a history of anxiety or depression prior to pregnancy, certain antidepressants can be safe to continue during pregnancy and you should consider this if you and your doctor believe it is necessary.
With that being said, there is also a new medication or treatment option that became available to the public called Zulresso by Sage Therapeutics. Let me answer some real life questions about it so you can discuss with your physician if it may be an option for you!
What is Zulresso? It is a prescription medication used in adults to treat moderate to severe postpartum depression as of June 24, 2019.
Where do I go for this infusion and for how long? It is a 60 hour continuous infusion or 2.5 days. There are certain sites in your city where the infusion is being administered and you have to stay there the whole time to be monitored. You doctor can help you find a site or you can call 1-844-4-SAGERX for information. You would have to see if the site allows for your baby to stay with you or not. Most likely allow visitors and will allow you to keep your baby with an adult present.
Can you take it while you are pregnant? Right now the effects of taking it during pregnancy are unknown so should be avoided.
Can you breastfeeding during the treatment? The medication does pass into the breastmilk, but the relative infant dose is low so talk to your doctor about your options.
So how do I qualify to receive the medication? Most of the patients that receive this medication have a score of 13 or greater on the Edinburgh Postpartum Depression Scale. That’s the questionnaire you take at your postpartum visit. Your provider can send in an order form to the company and the process starts.
But do I really have to pay $37,000?! No! Sage Central will enter all commercially insured patients into a financial assistance program and so far the highest copay in Arizona that a patient had to pay was $6!
Will it help me? In the trial 141 women were enrolled and they took a survey at the end of the 60 hours of infusion and again 4 weeks later and they found most women had a 62% reduction in symptoms at both time points per a questionnaire that the women took. Most of the women treated were 6 weeks to 6 months postpartum. The company doesn’t know the benefits after one month mark, but they believe they are promising and positive for it’s continued improvement on postpartum depression.
How does it work? There is a chemical in the brain called GABA that is involved with mood and emotion and this medication works on that receptor.
What are the side effects? The most common are sedation, dry mouth, loss of consciousness or hot flashes but very low chance. You will be monitored the whole time during the infusion, so if there is a problem a professional can help you.
I have not personally had a patient use this medication to date since it is so new, but knowledge about all your options is power! I just want women to know that it is available and get the facts behind what you read online about this medication, since there are sometimes not credible sources who give their two cents.
Overall, it is important to understand that one in seven women experience postpartum depression so it is common and the best thing is that this is a treatable condition! So don’t stay quiet ladies, make your voices heard about how you feel. You are not crazy, this is a condition that is real and should be addressed!
Remember support groups can be found at the hospital where you delivered or in your local community. Some online resources include:
-www.postpartum.net
-www.knowppd.com
-www.postpartumdepression.org
-www.womenshealth.gov
To get involved in the fight against maternal mental health issues, please visit https://wmmhday.postpartum.net
Read it, Learn it, Share It.
Dr. E
Photo by Luis Galvez on Unsplash
“The funny thing about our passion is it’s the reason we lose it and the reason we hold it together.”