Giving birth can trigger a flood of intense emotions, from joy to anxiety. Some women experience deep despair, known as postpartum depression, that can last for months. Women with this condition are often severely impaired in their ability to care for themselves and their babies. Any other children they may have may also suffer neglect.
How Is Postpartum Depression Treated?
Doctors frequently prescribe antidepressants to treat postpartum depression. Unfortunately, many of these medications take weeks or even months to work. That is why some healthcare providers are enthusiastic about a new option.
The FDA has just approved brexanolone to treat postpartum depression. This drug is a synthetic version of the neuro-hormone allopregnanolone. It works relatively quickly: after a 60-hour infusion, women participating in the trials showed improvements on a scale designed to measure depression. For women suffering severe postpartum depression, the difference from placebo was significant.
The drug, to be sold under the brand name Zulresso, carries a number of risks, including excessive sedation and loss of consciousness during the infusion. That’s why it will be administered only in qualified hospitals.
How Much Will Zulresso Cost?
Analysts expect the new drug to be extremely expensive. Uninsured women and even those with some insurance will probably have difficulty footing the $34,000 bill.
Previous Research on Postpartum Depression:
Some prior research on this serious condition focused on the possibility that omega-3 fatty acids found in fish oil might be helpful. Psychiatrists in Canada reported that women with low levels of omega-3 fats are at higher risk for postpartum depression (Canadian Journal of Psychiatry, November 2012). Levels of this critical nutrient drop in the mother during pregnancy while fetal stores increase. Omega-3 levels stay low for at least six weeks after a woman gives birth.
Boosting omega 3 fatty acids by taking fish oil or eating fish low in mercury might reduce the risk of postpartum depression. Pregnant women should avoid high-mercury fish such as shark, swordfish, tile fish and king mackerel.
How Well Does Fish Oil Work?
Australian researchers gave 2,000 pregnant women either vegetable oil as a placebo or fish oil capsules with 800 mg DHA daily and 100 mg EPA (Journal of the American Medical Association, Oct. 20, 2010). Fortunately, the study uncovered only one uncomfortable effect: the typical fish oil burp was twice as common among women taking fish oil as among those taking vegetable oil.
Sadly, the main results were disappointing. The women taking fish oil were no less likely to experience postpartum depression, and their infants were no more advanced in language or cognitive behavior at a year and half than those on placebo.
The women were, however, less likely to give birth prematurely. That risk dropped from two percent to about one percent. Perhaps in the future women will be encouraged to take fish oil during pregnancy. If they develop severe postpartum depression, the new medication could be a viable option if insurance will cover it.