A New Study: Postpartum Depression and the Medication, Citalopram (Celexa)
While postpartum depression (PPD) refers to the period after the birth of a baby and the symptoms experienced by the mother, relief for the condition is similar to that prescribed for anyone suffering from the debilitating effects of depression.
For a number of patients, psychotherapy is sufficient to bring relief and to help the patient learn new strategies, gain insight, transform, and grow. For others, this remedy alone is not enough, and requires a combination of therapy and medication.
In those cases, I am an enthusiastic supporter of whatever tools will help to get a woman well, medication included.
While determining the most effective medication that will have the fewest side effects, which is important for all who will be taking any drug, it is especially crucial for a mom who may be breastfeeding her newborn.
This introduction comes because of my interest in a new study recently published in Medical News Today, which appears to trumpet the drug Citalopram (Celexa) as top choice for postpartum depression. The research was conducted by scientists from Ohio State University and presented at Neuroscience 2014. It comprised of examining the brain cells of rats that were chronically stressed during pregnancy.
The research focused on an area within the brain that controls the reward system — the nucleus accumbens. This site was chosen because the scientists suspected that stress during pregnancy altered the reward system in the brain producing an inability to feel pleasure (anhedonia), “making depressed mothers less rewarded by their offspring and less motivated to take care of them.”
Citalopram is an SSRI — selective serotonin reuptake inhibitor — that promotes the amount of serotonin in the brain and results in better and more stable moods. When the researchers prescribed the drug for stressed mothers, they found that mood was improved and the effects of stress reversed.
While this is encouraging, I’m not cheerleading because drugs can have side effects. If you were to check those for Citalopram, this is what you’d find:
“Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.”
And then there’s this: “FDA pregnancy category C. Taking an SSRI antidepressant during pregnancy may cause serious lung problems in the baby.”
Plus, “Citalopram can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using citalopram.”
Needless to say, pregnancy and postpartum depression also pose significant risks to baby and mother. Although psychotherapy is safe for both, when medication is needed there is always need to do a risk-benefit analysis.
So, we have a conundrum: what’s a woman to do when suffering from PPD? My suggestion is to first turn to a therapist who specializes in the condition.
If you both determine the PMAD is so severe that medication is needed, add to your team a psychiatrist with specialization in perinatal issues. Then, determine which of the various medications available, are the most effective and the safest for that individual patient and her baby.
The Post-Postpartum Depression Blog 