The FDA just approved a pill for postpartum depression. Here’s what that means

Read the Full Transcript

• John Yang:

  Postpartum depression is among the most common complications of childbirth. Every year, it afflicts about a half million American women and it's among the leading causes of pregnancy related death. And yet the Centers for Disease Control and Prevention estimates that more than half of the women experience it are never treated for it.

  Now, the Food and Drug Administration has approved the first pill for postpartum depression. Patricia Kinser is co-director of Perinatal Mental Health Research at Virginia Commonwealth University's Institute for Women's Health.

  From your perspective, how significant is this development?

  Patricia Kinser, Virginia Commonwealth University School of Nursing: So, as a clinician and researcher, I constantly work with pregnant and postpartum people who share feelings of stigma and shame around their depression and anxiety symptoms.

  So, I think the most significant aspect of this development is that it may normalize the concept of postpartum depression. It will make family members, friends, even healthcare providers just that much more aware of the significance of depression and anxiety symptoms and they might help support that new mom in seeking help when there are those symptoms.

  So that is what is most exciting to me, in addition to, of course, the important groundbreaking work of this research, but that the field of maternal mental health is receiving the attention that is needed.

  So, you know, as you mentioned, mental health conditions during and after pregnancy are among the leading causes of preventable maternal deaths in the United States at any given time. Close to 4 million American women are in the perinatal period. So whether they're pregnant or postpartum, up to one year after delivery.

  And of these, at least one in five experience depression symptoms. And certainly we saw these rates rise during the pandemic. So notably, many of them have unrecognized or untreated symptoms that now with this increased recognition of the need for treatment, we're hoping that those women can receive the treatment that they need.

• John Yang:

  What distinguishes postpartum depression from other conditions that a new mother may be feeling? And when is it time for them to seek help?

• Patricia Kinser:

  This medication is one piece of a larger puzzle of tending to maternal mental health. So because we know that symptoms are so common and with depression, they are the, quote unquote, typical symptoms we might hear about in terms of sadness, feeling extremely blue, suicidality, difficulty with sleeping, difficulty with eating.

  But also in the maternal phase, we see these symptoms overlapping with extreme anxiety, concerns about inability to take care of the child, inability to take care of themselves. So we have to create a standard of care whereby all people who are pregnant and in the postpartum period are screened for symptoms and screened in a way that there is responsive care provided when they do receive screening.

  Some patients tell us that even though they are screened, they might not feel heard or that the resources might not be made available to them. Or secondly, providers often don't feel like they have the time or resources or experience to help provide the support to women who are having those symptoms.

  So, we encourage that while this medication development is so important, an important piece of this puzzle is thinking ahead early, looking at emotional wellness during pregnancy before these symptoms of overwhelm. A lot of the moms we talk with when they start experiencing these symptoms, it's hard to recognize and act on them at first because they're so busy with everything else. They're busy with taking care of the new baby, maybe other family members, children in their family.

  So, sometimes the symptoms remain untreated for a while until they become debilitating. And that's almost getting to be too late. We want people to have their symptoms recognized, early resources provided to them early.

• John Yang:

  As I understand it, there has been an injectable form of treatment that's been around for a couple of years. What's the difference between the pill and the injection? Does it make it easier to use?

• Patricia Kinser:

  So the IV medication, while being very effective, means that it requires that postpartum person to be away from their new baby or away from their family in order to receive that injected medication. So a pill form, as we know, with other medications used for mental health, when it can be taken at home in the safety of one's home, definitely makes it more accessible and less stigmatizing.

  But certainly we need to caution that this medication has not been tested in people who intend to breastfeed, which could still limit accessibility right now because many postpartum individuals are choosing to breastfeed. So that's an area for future research.

• John Yang:

  Are there side effects that are common enough and severe enough that may discourage use?

• Patricia Kinser:

  Sleepiness and dizziness seem to be the most common side effects. Certainly with any kind of medication that's used for mental health, we also see a slight increased risk of suicidality. So, family members do need to be aware to keep an eye out for increased suicidality.

  And we also should point out that this medication might not be ideal for people who have preexisting or recurrent depression symptoms, because this medication has only been tested for use for 14 days. So someone with recurrent depression likely needs to be on a medication continuously and not stop at that 14 days. So, again, there's opportunities for future work.

  But this is a great start, especially for people for whom depression might be a new experience or it might be a bridge to other long term medications.

• John Yang:

  Patricia Kinser of Virginia Commonwealth University School of Nursing. Thank you very much.

• Patricia Kinser:

  You're welcome.