Zuranolone for the Treatment of Postpartum Depression

American Journal of Psychiatry, Journal Year: 2023, Volume and Issue: 180(9), P. 668 - 675

Published: July 26, 2023

Postpartum depression (PPD) is a common perinatal complication with adverse maternal and infant outcomes. This study investigated the efficacy safety of zuranolone, positive allosteric modulator synaptic extrasynaptic GABAA receptors neuroactive steroid, as an oral, once-daily, 14-day treatment course for patients severe PPD.In this double-blind phase 3 trial, women PPD were randomized in 1:1 ratio to receive zuranolone 50 mg/day or placebo 14 days. The primary endpoint was change from baseline total score on 17-item Hamilton Depression Rating Scale (HAM-D) at day 15; key secondary endpoints HAM-D days 3, 28, 45 Clinical Global Impressions severity (CGI-S) 15. Adverse events monitored.Among 196 (zuranolone, N=98; placebo, N=98), 170 (86.7%) completed 45-day study. Treatment compared resulted statistically significant improvement depressive symptoms 15 (least squares mean [LSM] score, -15.6 vs. -11.6; LSM difference, -4.0, 95% CI=-6.3, -1.7); also reported 45. CGI-S significantly improved placebo. most (≥10%) somnolence, dizziness, sedation. No loss consciousness, withdrawal symptoms, increased suicidal ideation behavior observed.In demonstrated improvements generally well tolerated, supporting potential novel, rapid-acting oral PPD.

Language: Английский

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The lived experience of postpartum depression and psychosis in women: a bottom‐up review co‐written by experts by experience and academics

World Psychiatry, Journal Year: 2025, Volume and Issue: 24(1), P. 32 - 45

Published: Jan. 15, 2025

This is the first bottom‐up review of lived experience postpartum depression and psychosis in women. The study has been co‐designed, co‐conducted co‐written by experts academics, drawing on first‐person accounts within outside medical field. material initially identified was shared with all participants a cloud‐based system, discussed across research team, enriched phenomenological insights. subjective world characterized sudden onset (“being hit ton bricks”), unbearable loneliness sadness that are often suffered silence, inability to feel positive emotions, grieving over loss self, feelings being bad mothers (haunted suffocating burden guilt due that), concentrate, lack control thoughts (“feeling like tightrope walker without emotions”), insecurity (up needing be nurtured mothered themselves), death (“contemplating as glimmer hope escape living nightmare”). In addition these themes, difficulty articulating brain centrifuge”); perceptual abnormalities unusual beliefs disrupting sense personal unity (with, few cases, harming themselves or their baby, so women may they “sinking depths hell”); losing trust (“ploughing through fog safety”), stripping down relationships. Much isolation, disorientation experienced conditions relates sociocultural family environments, especially gulf between how web norms expectations surrounding motherhood. most stigma related knowledge what are. Stigma core drivers impacting health care terms seeking professional help, accessing mental services, receiving pharmacological psychological treatments. narratives described this paper should inform clinical practice, public education. brings voice unspoken unheard, fosters relational connections which different mothering experiences expressed understood. vital challenging negative attitudes towards psychosis, providing supportive experiencing such pervasive psychiatric disorders at critical, fragile time lives.

Language: Английский

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Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troubles de l'humeur, des troubles anxieux et des troubles connexes périnatals

The Canadian Journal of Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 12, 2025

Background The Canadian Network for Mood and Anxiety Treatments (CANMAT) publishes clinical practice guidelines mood anxiety disorders. This CANMAT guideline aims to provide comprehensive guidance the pregnancy postpartum (perinatal) management of mood, related Methods convened a core editorial group interdisciplinary academic clinicians persons with lived experience (PWLE), 3 advisory panels PWLE perinatal health mental clinicians. We searched systematic reviews prevention treatment interventions depressive, bipolar, anxiety, obsessive–compulsive post-traumatic stress disorders (January 2013–October 2023). prioritized evidence from randomized controlled trials (RCTs), except safety medications where large high-quality observational studies were due absence RCT data. Targeted searches individual conducted when limited or absent. Recommendations organized by lines based on CANMAT-defined levels quality, supplemented consensus balance efficacy, safety, tolerability feasibility considerations. Results covers 10 sections in question-and-answer format that maps onto patient care journey: case identification; organization delivery care; non-pharmacological (lifestyle, psychosocial, psychological), pharmacological, neuromodulation complementary alternative medicine interventions; high-risk situations; father co-parent. Equity, diversity inclusion considerations are provided. Conclusions guideline's detailed evidence-based recommendations key information promote effective safe healthcare. It is hoped will serve as valuable tool Canada around world help optimize outcomes area health.

Language: Английский

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Postpartum Depression: Overview and Management

Journal of Comprehensive Health, Journal Year: 2025, Volume and Issue: 0, P. 1 - 7

Published: Feb. 13, 2025

The mental health of a mother during her pregnancy has significant impact on the mother, child, and family. Psychopathologies such as postpartum depression (PPD) are among most common. Many women reluctant to acknowledge their sadness others after having child. Postpartum hormone fluctuations may be cause baby blues. PPD is characterized by symptoms depression, ongoing melancholy, disinterest, low self-esteem, disturbed sleep, appetite loss, anxiety, impatience with hostile attitude toward newborns, self-blame, feelings humiliation. There been lot published about symptoms, risk factors, therapies for PPD, but not much research done why wait so long get therapy. Remission, or resolution depressive aim treatment. It could required coordinate therapists refer patients psychiatrists antidepressant medication. A complete recovery depends early discovery

Language: Английский

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Relatively independent and complementary roles of family history and polygenic risk score in age at onset and incident cases of 12 common diseases

Social Science & Medicine, Journal Year: 2025, Volume and Issue: 371, P. 117942 - 117942

Published: March 8, 2025

Language: Английский

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Mental Health Challenges in the Postpartum Period

IntechOpen eBooks, Journal Year: 2025, Volume and Issue: unknown

Published: March 3, 2025

The postpartum period presents significant mental health challenges, with many women experiencing mood and anxiety disorders that can greatly impact both maternal infant well-being. Early accurate screening for conditions is crucial ensuring timely diagnosis intervention. Postpartum depression (PPD) the most common, affecting up to 15% of new mothers, characterized by persistent sadness, fatigue, feelings inadequacy. Anxiety disorders, often underdiagnosed, manifest as excessive worry, intrusive thoughts, panic. Left untreated, impair a mother’s ability bond her infant. A psychiatric emergency in psychosis, rare but severe condition may involve delusions, hallucinations, risk mother baby, requiring immediate medical attention. Additionally, post-traumatic stress disorder (PTSD) develop after traumatic birth or loss an infant, further complicating recovery health. Prompt identification treatment these through universal targeted care mitigate long-term consequences improve outcomes mothers their families. This manuscript highlights critical importance calls greater awareness resources support during this vulnerable time.

Language: Английский

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Mental Health After Childbirth in Women with Previous Bariatric Surgery: The SPOtMom Pilot Study

Experimental and Clinical Endocrinology & Diabetes, Journal Year: 2025, Volume and Issue: 133(03), P. 112 - 119

Published: March 1, 2025

Abstract Currently, no data are available using standardized instruments for evaluating the postpartum mental health of women with previous bariatric surgery. The aim this pilot study was to assess in following surgery and establish appropriate tools a prospective registry future. In survey, 22 during first weeks examined (T1) their status at least 6 months after childbirth prospectively assessed (T2). Symptoms depression anxiety were evaluated questionnaires diagnosed structured diagnostic interviews (SCID-5). At T1, 3/22 (14%) reported depressive or symptoms, these women, diagnosis established. comparison T2, symptomatology increased 32% 27% patients, respectively, but only one woman depression. patients without signs both had lower total body weight loss and, more often, personal family history disorders. Our suggests that rate BS might be higher than general population. High symptom levels emphasize necessity long-term follow-up care. Further research is needed evaluate if prevalence disorder patient group as compared other

Language: Английский

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The HOPE cohort: cohort profile and evaluation of selection bias

European Journal of Epidemiology, Journal Year: 2024, Volume and Issue: 39(8), P. 943 - 954

Published: Aug. 1, 2024

Abstract The HOPE cohort is a Danish nationwide with ongoing follow-up, holding information on postpartum depression (PPD) symptoms and diagnoses 170,218 childbirths (142,795 unique mothers). These data have been linked extensive register health socioeconomic the mothers, their partners, parents, children. This profile aimed to provide an overview of collection content, describe characteristics, evaluate potential selection bias. PPD screenings, using Edinburgh Postnatal Depression Scale, were collected from 67 98 municipalities, covering period January 2015 December 2021. was (identified through medication prescriptions hospital contacts) as well background information. Cohort characteristics compared source population, defined all by women residing in Denmark during same (452,207 childbirths). Potential bias evaluated comparing odds ratios five well-established associations between population. holds (38% population) involving 142,795 mothers. only differed slightly population most examined, but larger differences observed specific underrepresentation youngest oldest age groups, more than three children or twins/triplets, born outside Denmark. Similar identified across two populations within associations. There no indication examined associations, representative important perinatal characteristics.

Language: Английский

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Social Support and Postpartum Depressive Symptoms in Portuguese Women: The Mediating Role of Emotion Regulation Difficulties

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7150 - 7150

Published: Nov. 26, 2024

Background/Objectives: Postpartum depression (PPD) is a prevalent mental health issue affecting 14% of mothers worldwide, with long-term implications for both maternal and child well-being. Understanding the factors contributing to PPD essential developing effective interventions. This study aimed investigate relationship between social support postpartum symptoms, focus on mediating role emotion regulation difficulties. Methods: A sample 160 women (M age = 33.57, SD 4.94) participated in study. Participants were assessed their levels perceived support, difficulties regulation, symptoms PPD. Results: The results indicated that lower significantly associated greater (effects ranging from −0.10 0.07). These turn linked higher −0.29 0.78), suggesting partial mediation effect emotional awareness (95% CI −0.05, −0.00), non-acceptance emotions −0.04, difficulty goal-directed behavior limited access strategies −0.12, −0.04). Conclusions: findings underscore critical development symptoms. Enhancing skills, particularly could be key target interventions at reducing risk severity

Language: Английский

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Disentangling the Genetic Landscape of Peripartum Depression: A Multi-Polygenic Machine Learning Approach on an Italian Sample

Genes, Journal Year: 2024, Volume and Issue: 15(12), P. 1517 - 1517

Published: Nov. 26, 2024

Background: The genetic determinants of peripartum depression (PPD) are not fully understood. Using a multi-polygenic score approach, we characterized the relationship between genome-wide information and history PPD in patients with mood disorders, hypothesis that multiple polygenic risk scores (PRSs) could potentially influence development PPD. Methods: We calculated 341 PRSs for 178 parous disorder inpatients affected by major depressive (MDD) or bipolar (BD) (n = 62) without 116) used partial least squares regression novel machine learning pipeline to rank based on their contribution prediction PPD, whole sample separately two diagnostic groups. Results: PLS linear defined model explaining 27.12% variance presence history, 56.73% among MDD, 42.96% BD. Our findings highlight factors related circadian rhythms, inflammation, psychiatric diagnoses top contributors Specifically, contributing PRS was monocyte count, while BD, it chronotype, inflammation significantly both Conclusions: These results confirm previous literature about immune system dysregulation postpartum shed light which involved pathophysiology

Language: Английский

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