by Maria Giovanna Faiella
Before being available in Europe and Italy, it must have the go-ahead from the EMA and AIFA regulatory authorities. In Italy, the pathology affects one out of 10 new mothers. How to prevent it, symptoms
The birth of a child is a joyful event, but it can happen that the new mother, after giving birth, is affected by postpartum depression, a real pathology that needs to be treated. Now, in the United States, there is one more tool for dealing with postpartum depression: the American agency Fda-Food and Drug Administration (Food and Drugs Regulatory Agency) has approved the drug zuranolone, the first specific oral treatment for postpartum depression.
It should be remembered that the medicine, before being actually available in our country, must be authorized for marketing by the European regulatory body EMA-European Medicines Agency and then by the Italian one, AIFA-Italian Medicines Agency.
Fast-acting drug
So far, serotonergic antidepressant drugs have been used above all even in the post-partum period, but they have rather long action times, in the sense that they act on average after 15-20 days – explains Dr. Emi Bondi, president of the Italian Society of Psychiatry (Sip) and director of the mental health department of Asst Papa Giovanni XXIII in Bergamo – . The drug approved by the FDA on the basis of experimental studies – the most recently published in the American Journal of Psychiatry – promises to be one more tool for treating postpartum depression. The main feature of the medicine is the great rapidity of action: according to the studies carried out, it already works after three days, that is, on the third administration there is already an antidepressant effect – explains Bondi -. It is a neurosteroid or a steroid, a hormone synthesized from progesterone which, together with estrogen, is one of the female hormones that make the female sexual cycle and pregnancy possible. But we also know that, probably, the greater vulnerability that the female sex has for anxiety disorders and depression (up to 4 times more), compared to the male sex, is linked to the fluctuations of these hormones. The approved drug’s mechanism of action is to act on GABAergic receptors in the brain, which regulate stress and mood.
So it regulates stress and mood
In practice, with the drug there is a sort of “signaling pathway” that helps regulate stress and mood. one of the mechanisms by which hormones can determine mood fluctuations that also occur during the cycle, in the premenstrual phase when you are more anxious and irritable “because” of progesterone – explains Dr. Bondi -. Since, after pregnancy, there is a sudden drop in hormones – increased by about 10 percent during pregnancy -, the hypothesis that it may also be the basis of the origin of depression that arises after childbirth, generally after about 15 days and which can last up to six months.
Baby bues or depressive state?
In our country, postpartum depression is a pathology that affects about one out of ten new mothers, but must be distinguished from Baby Bues. Depression must be prevented and treated – underlines the president of the Italian Society of Psychiatry -. Women shouldn’t feel guilty if after giving birth they are tired, stressed, sometimes find it difficult to manage the newborn, because motherhood, in addition to being a joyful event, is also a physically and mentally tiring period. In general, in the post-partum period, all women have a few days of low mood, the so-called “blue period” (or “baby ox”, in the past called “tears of milk”): physiological and determined precisely by the drop in hormones that occurs with childbirth. However, in 10 per cent of cases – Dr. Bondi points out – a depressive pathology may arise which is important to identify and treat as it has repercussions not only on the mother, but also on the child and their relationship. If the new mother is not well, she must get help, without any prejudice.
Recognize the symptoms and get help
What are the “tell” symptoms that something is wrong and what to do? The new mother feels excessively tired, she can’t sleep, she becomes sad, she cries, she fears she won’t be able to take care of the baby as she should, she becomes apathetic – summarizes Dr. Bondi -. In these cases she should not be left alone but helped, without blaming her, first of all by those close to her and, if necessary, in the case of a real depressive illness, even with pharmacological treatments, as well as with the psychological support that may already exist during the period of pregnancy. In fact, there are postpartum depression prevention programs that aim to follow the woman during pregnancy and, if necessary, continue to do so even in the postpartum period. Some programs provide home assistance from midwives or dedicated personnel to help the new mother in a practical way, when she returns home, to manage the baby.
August 5, 2023 (change August 5, 2023 | 19:33)
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