Antidepressants Alleviate Postpartum Depression, But Risks Must Be Weighed

Although previous reports focused on the risks of antidepressant use in new mothers, a recent study stressed the benefits these drugs provide for women with postpartum depression.

Although previous reports focused on the risks of antidepressant use in new mothers, a recent study stressed the benefits these drugs provide for women with postpartum depression.

This study, which was published in the Journal of the American Medical Association, analyzed 6 randomized, controlled trials that enrolled a total of 596 women, all of whom were treated over a period of 6 to 8 weeks.

The research team found 54% of those with postpartum depression who were treated with selective serotonin re-uptake inhibitors (SSRIs) had “much improved” symptoms, or a >50% reduction in symptom severity. Comparatively, only 36% of women who received placebo reported such improvements.

Additionally, the researchers discovered antidepressant use was associated with improved depression remission rates, with 49% of SSRI-treated participants experiencing remission, compared with 26% of the placebo group.

“Our findings are important due to the limited research exploring the use of antidepressants to treat postnatal depression,” explained co-author Emma Molyneaux, MSc, of the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in a press release. “We would urge that treatment decisions during the postnatal period consider the potential benefits as well as risks of medication, as well as the risks of untreated depression for both mother and baby.”

More than 10% of mothers experience postpartum depression within a year of giving birth, according to a press release from the school.

Senior study author Louise Howard noted “some antidepressants are safer than others for mothers who are breastfeeding, so mothers seeking advice for depressive symptoms should ensure that their doctor knows if they are breastfeeding.”

In an exclusive interview with Pharmacy Times, Dr. Howard encouraged pharmacists to discuss the importance of antidepressants with mothers who have postpartum depression, including those who are breastfeeding.

“I think that it is important for pharmacists to be aware that antidepressants are essential for some women with postnatal depression, particularly those with more severe illnesses or a history of severe depression,” Dr. Howard told Pharmacy Times in an exclusive interview. “Many women understandably worry about taking medication when they are breastfeeding, but for most antidepressants, only very small amounts are found in breast milk.”

Women with postpartum depression should also discuss the benefits of medication and other treatments with their prescribers, Dr. Howard suggested.

“Postnatal depression is very treatable with either psychological treatments or (sometimes and) antidepressants, and the choice of treatment depends on severity, past response to treatment and patient preferences,” she said. “It is disabling, as it prevents women being able to enjoy this important time in their lives and can prevent them functioning due to their symptoms. It is therefore important to seek help for treatment as early as possible.”