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Postpartum depression medications: What to know

Postpartum depression medications: What to know

There isn’t necessarily a best medication for postpartum depression.

Reviewed by:
Divya Khosla, MD
|
View bio
June 6, 2024
Original source:

Key takeaways

  • Antidepressants like SSRIs can be prescribed for the treatment of postpartum depression.
  • You can also take Zurzuvae, the firstFDA-approved oral medication for PDD.
  • Most medications are safe to take while breast feeding, but ask your doctor about any risk factors.
In this article

Up to 19% of new mothers experience a mental health condition called postpartum depression. This mental health condition is a form of depression that may involvesfrequent crying, irritability, mood swings, and feelings of being overwhelmed. It’s more severe than the baby blues (but not as intense as another rare but serious condition called postpartum psychosis). You may begin feeling symptoms of postpartum depression around one week after giving birth. However, women may be diagnosed at any time during the first year postpartum.

The good news is that postpartum depression is highly treatable. With therapy and medication, you’re likely to feel like yourself again in no time. In this article, we’ll discuss what medications commonly treat postpartum depression, how to get a prescription, and potential side effects.


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What medications treat postpartum depression?

Doctors commonly prescribe several types of antidepressants to treat major depressive disorder. The same medications are frequently prescribed in an off-label capacity to treat anxiety disorders, mood disorders, and postpartum depression. Off-label uses are very common and safe. This designation simply means the FDA hasn’t approved the medication for that specific condition, although there is research to show its effectiveness.  

The most common types of antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs): SSRIs are a class of antidepressant medications that block neurons from reabsorbing serotonin—one of the brain’s chemicals responsible for mood regulation. This means there’s more serotonin available in your brain to regulate your mood and transmit messages between neurons. SSRis include Zoloft (sertraline) and Prozac (fluoxetine)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs block the reuptake of serotonin, just like SSRIs, but they also block the reuptake of norepinephrine—a chemical that helps control your attention and stress response.
  • Atypical antidepressants: Atypical antidepressants are a group of antidepressant medications that can’t be categorized in another antidepressant class. They typically affect your brain chemistry similarly to SSRIs and SNRIs, although each one does something slightly different.

There are many different antidepressants your doctor may recommend based on your health history and symptoms. They may consider current FDA approved medications like Zurzurvae (zuranolone), the first FDA-approved oral medication for PPD. There’s also Zulresso, also known as Brexanolone, which has to be administered as an infusion in a hospital rather than at home. There may be barriers to accessing these medications including insurance coverage.

Here’s more on Zurzuvae, including how it works in detail on GABA and allopregnanolone,

Which postpartum medication is the best one for me?

Different medications and doses work for different people when it comes to depression, including the kind you might experience after giving birth. Your doctor will ask about your medical history, symptoms, and breastfeeding plans before prescribing the best medication for postpartum depression.  

Finding the right dose and medication sometimes takes a few tries, so don’t be discouraged if the first one doesn’t work how it should. Keep note of your symptoms and whether you begin feeling better a few weeks after starting a new medication. If not, your doctor can adjust your dose or help you find a new medicine to try.  

What are the side effects?

Antidepressants, like any medications, sometimes cause unwanted side effects. Don’t worry, most side effects are mild and temporary while your body adjusts. If they’re overwhelming or you experience an allergic reaction to your medicine, let your doctor know immediately.

Each postpartum depression medication has slightly different potential side effects, which your doctor will go over with you before prescribing any one of them. Here are some common ones that you may encounter.

Common side effects of antidepressants

  • Decreased appetite, nausea, constipation, dry mouth
  • Sedation, insomnia, dizziness
  • Headaches
  • Tremors, agitation, anxiety
  • Sweating
  • Low sex drive  

Severe side effects of antidepressants

Zurzuvae comes with other side effects related to your central nervous system, like drowsiness.

How do you get postpartum depression medication?

The most common way to get mental health treatment, including medication, is through your current doctor or a psychiatrist. Here are the steps you’ll take to get a prescription.

Meet with your primary care doctor

The first step in treating your mental health concerns is working with your current doctor. Make an appointment with your OB/GYN or primary care physician—whoever is treating you during your postpartum period. Let them know how you’re feeling. Try to be as open and honest as possible during your conversation with them since they’ll likely provide a referral to a psychiatrist or may be able to prescribe your medication directly.

Get a referral for a psychiatrist

If your primary care doctor doesn’t prescribe your medication themselves, they’ll likely refer you to a psychiatrist to do so. Some insurance plans also require a referral before seeing a psychiatrist, so make sure to check your plan details. Here’s more on whether you need a referral to see a psychiatrist.

Complete an evaluation

Early in your treatment, your psychiatrist will likely schedule a diagnostic evaluation appointment with you. This is where you can explain your situation and symptoms, and they can confirm a PPD diagnosis and treatment plan.  

Not sure where to start when it comes to finding a psychiatrist? Meet Talkiatry. At Talkiatry, we can help you get a personalized treatment plan that may include medication, therapy, or both. We’re a national psychiatry practice that provides in-network, virtual care—and you can schedule a first visit within days. Get started with a short online assessment.

Begin treatment

Once your psychiatrist prescribes medication and you discuss a treatment plan, it’s time to get started! Monitor your symptoms as you begin medication and/or therapy. Your doctor may change your dose or the medication you’re taking based on your feedback. If any unpleasant side effects arise, make sure to tell your psychiatrist right away.  


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Can you take medication for postpartum depression while breastfeeding?

Many antidepressants prescribed for postpartum depression are safe to take while breastfeeding. However, a small amount of your medication will likely transfer to the baby through your breast milk. This small amount is usually considered safe and isn’t a concern for the baby’s health. That said, it’s a good idea to talk to your psychiatrist and OB/GYN or PCP about the pros and cons of antidepressants before starting medication. They can inform you of any possible risks or specific medications to avoid when breastfeeding.

Can you treat postpartum depression without medication?

The decision to start medication is a personal one, and it’s not for everyone. That said, it’s important to know that help exists and that postpartum depression is treatable. Like major depression, PPD may last months, affect your quality of life, even interfering with your relationship with your new child.  

Medication isn’t the only way to treat postpartum depression. Implementing regular cognitive-behavioral therapy (CBT), support group sessions, and self-care practices are all great ways to improve your mental health. Make sure to work with your doctor to develop a treatment plan, and let them know whether or not you’re interested in taking medication.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Does Talkiatry take my insurance?

We're in network with major insurers, including:

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The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Divya Khosla, MD

Dr. Divya Khosla, MD, is a board certified Adult Psychiatrist and board eligible Child and Adolescent Psychiatrist. She received her undergraduate degree from Case Western Reserve University in Cleveland, Ohio, and her medical degree from Ross University, completing all of her clinicals in Maryland, D.C., and NYC. She completed her adult psychiatry residency at The Ohio State University in Columbus, Ohio. Then she returned to the east coast, where she completed her child and adolescent psychiatry fellowship at Nassau University Medical Center in East Meadow, New York.

Dr. Khosla has participated in a variety of innovative academic clinical research, and has presented research at annual national meetings of the American Psychiatric Association. Her robust clinical experience with varying demographics at different clinical sites around the country has allowed her to treat patients in an evidence-based way, tailoring treatment to an individual’s specific needs.

Although Dr. Khosla’s practice focuses on medication management, she also implements supportive therapy and motivational interviewing in sessions to allow for a more comprehensive approach to treatment. Her clinical interests include depression, bipolar disorder, anxiety disorders, post-traumatic stress disorder, panic disorder, and ADHD.

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