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FDA Approves First Oral Treatment for Postpartum Depression

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Re: FDA Approves First Oral Treatment for Postpartum Depression

#171

Post by haldujai »

zpeti wrote: post #165
mtlmtlmtlmtl wrote: post #150

Earlier quoted context omitted.

Thank you. I'll never understand why there's such a dominance of luddite thinking, bad takes and conspiracy theories on HN, when it comes to the topic of mental health. Especially when it comes to drug treatments. Psychiatry no doubt has a lot of problems with it. But it's also the only game in town for a huge amount of people. What's the alternative? Prayer circles? Ayahuasca tourist traps? Cannabis? Homeopathy? Giv…

It’s very easy to explain. By going straight to medication you are treating the symptom not the cause. And you don’t even know if it works. SSRIs don’t work for many people and we only found out 2-3 years ago. Opioids were prescribed to half of America for back pain. That gives scope for healthy scepticisms at least. Just because you might have some anecdotal evidence of some chemicals working, doesn’t mean it works…

> By going straight to medication

Initial treatment recommendations:

For mild to moderate postpartum unipolar major depression, we suggest psychotherapy as initial treatment. This approach is consistent with multiple practice guidelines, and is especially useful for lactating patients who do not want to expose their infants to antidepressants.

However, antidepressants (eg, selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors, bupropion, and mirtazapine) are a reasonable alternative if psychotherapy is not available, not successful, or is declined, or if the patient has previously responded to antidepressants.

In addition, combination treatment with pharmacotherapy plus psychotherapy is useful for some patients.

Source: UpToDate.

> And you don’t even know if it works.

While evidence for SSRIs is weak in meta-analyses this is not one of them. I will also agree that a single trial (i.e. the original post and what led to approval) is not definitive but does in fact suggest it works and will continue to be assessed in post-market studies.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#172

Post by rs_rs_rs_rs_rs »

RcouF1uZ4gsC wrote: post #24

I wonder how much of post-party depression is caused by isolation. In the past, new mothers were surrounded by a whole village of women who would help care for the woman and the baby. Many times now, women are isolated with maybe the father present. And even then there are pressures to get back to work. This isn’t to discount or minimize postpartum depression, but if we as a society set up people for failure which re…

> I wonder how much of post-party depression is caused by isolation.

I don't know how we would have managed the little one in the first years just the two of us. It really does that a village to raise a child, literally and figuratively.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#174

Post by haldujai »

NoZebra120vClip wrote: post #163
haldujai wrote: post #156

Earlier quoted context omitted.

It's insane to me that a group of educated and seemingly intelligent people seem to think they understand more about drug safety and prescribing than the FDA, researchers and physicians. This is reminiscent of the Texas district judge who decided to controversially overrule the FDA on a medication safety decision that recently made the news, not good company one wants to have and I'm hoping is coincidental than sugge…

[flagged]

What black box warning are you talking about?

The only one I see for Zurzuvae is: "IMPAIRED ABILITY TO DRIVE OR ENGAGE IN OTHER POTENTIALLY HAZARDOUS ACTIVITIES"[1]

[1]https://documents.sage-biogen.com/us/zurzuvae/pi.pdf

Re: FDA Approves First Oral Treatment for Postpartum Depression

#175

Post by pertymcpert »

sixo wrote: post #55
nocoiner wrote: post #42

Earlier quoted context omitted.

Ah yes. The good ol’ “Well, have you tried not being depressed?” Works every time.

OP said nothing of the sort. They clearly described a dysfunction in the surrounding support structure, not the mother herself.

PPD can't be fixed by support structures.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#177

Post by mtlmtlmtlmtl »

zpeti wrote: post #165
mtlmtlmtlmtl wrote: post #150

Earlier quoted context omitted.

Thank you. I'll never understand why there's such a dominance of luddite thinking, bad takes and conspiracy theories on HN, when it comes to the topic of mental health. Especially when it comes to drug treatments. Psychiatry no doubt has a lot of problems with it. But it's also the only game in town for a huge amount of people. What's the alternative? Prayer circles? Ayahuasca tourist traps? Cannabis? Homeopathy? Giv…

It’s very easy to explain. By going straight to medication you are treating the symptom not the cause. And you don’t even know if it works. SSRIs don’t work for many people and we only found out 2-3 years ago. Opioids were prescribed to half of America for back pain. That gives scope for healthy scepticisms at least. Just because you might have some anecdotal evidence of some chemicals working, doesn’t mean it works…

Look.

It's not some earth shattering revelation that "SSRIs don't work for many people". This has been known since SSRIs first appeared on the scene. This is also true of any other treatment you can think of. The reason they became the first choice as far as antidepressants go is they were a lot safer and better tolerated than the older alternatives. Besides, there's a lot more to psychiatry than just SSRIs. But with people like you it's always about SSRIs. Can't shut up about the SSRIs. If you hadn't noticed, this new drug is not an SSRI!

Psychiatrists recommend therapy, they recommend changes in diet and they recommend exercise. Clinical psychology, though technically a separate discipline from psychiatry, not being under the umbrella of medicine, is very much developed, researched and practiced in tandem and cooperation withpsychiatry, and vice versa.

You're constructing an elaborate strawman here, where the only reason for using drugs is some evil financial motive. It's just not that simple. There bad apples, and perverse incentives, but not only bad apples. Most doctors do in fact care about helping their patients.

Therapy can't fix everything. Therapy alone is not always sufficient and can be just as hit and miss as medication. Not everything is some deep personal issue that needs to be analysed and resolved. Mental disorder is often genetic, even neurological in nature. All the therapy in the world won't stop a bipolar person from cycling between mood disturbances, or someone with ADHD from being unable to concentrate.

We can't throw the baby out with the bathwater. Medication, therapy, meditation, diet, exercise, sleep hygiene are all part of the psychiatric toolbox.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#178

Post by haldujai »

rs_rs_rs_rs_rs wrote: post #173
aaronbrethorst wrote: post #170

Earlier quoted context omitted.

With all due respect, fuck off. How dare you question my lived experience.

[flagged]

UpToDate is paywalled but here is a relevant excerpt for you on postpartum paternal depression which is a very real diagnosis:

New fathers may develop depressive symptoms or disorders. Postpartum paternal depression can interfere with paternal-infant bonding and is associated with adverse effects upon child development.

Prevalence — Based upon studies that used diagnostic interviews, the estimated prevalence of postpartum paternal depression ranges from 3 to 5 percent:

●One study interviewed fathers (n >2000) of infants and found that the prevalence of postpartum major depression was about 5 percent.

●A study of a clinical database that included new fathers (n >86,000) found that by the time their children were one year old, an episode of postpartum depression had occurred in 3 percent.

Given that you acknowledge depression I expect your misunderstanding is the fact that postpartum depression is defined as unipolar major depression occurring within 12 months after birth, it is not sex specific and can be either maternal or paternal.

https://www.uptodate.com/contents/postpartum-paternal-depres...

Re: FDA Approves First Oral Treatment for Postpartum Depression

#179

Post by throwaway2037 »

astrange wrote: post #113
RcouF1uZ4gsC wrote: post #24

I wonder how much of post-party depression is caused by isolation. In the past, new mothers were surrounded by a whole village of women who would help care for the woman and the baby. Many times now, women are isolated with maybe the father present. And even then there are pressures to get back to work. This isn’t to discount or minimize postpartum depression, but if we as a society set up people for failure which re…

PPD is more common in developing countries where this isn't true.

I tried to Google about this, but found nothing. Can you share a study? I am interested to learn more.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#180

Post by NoZebra120vClip »

haldujai wrote: post #174
NoZebra120vClip wrote: post #163

Earlier quoted context omitted.

[flagged]

What black box warning are you talking about? The only one I see for Zurzuvae is: "IMPAIRED ABILITY TO DRIVE OR ENGAGE IN OTHER POTENTIALLY HAZARDOUS ACTIVITIES"[1] [1] https://documents.sage-biogen.com/us/zurzuvae/pi.pdf

My bad - not a black box in this case. Just a regular box. Sorry for the confusion.
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