Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

FDA Approves First Oral Treatment for Postpartum Depression

fda.gov

Post reply on HN
Print view View original

221–230 of 299 posts

Re: FDA Approves First Oral Treatment for Postpartum Depression

#221

Post by NoZebra120vClip »

mtlmtlmtlmtl wrote: post #186
NoZebra120vClip wrote: post #163

Earlier quoted context omitted.

[flagged]

Hey, you know what causes suicide more than anything else? Depression. Especially untreated depression. And no, cannabis is not a mental health panacea now matter how many times you claim it is. In fact it generally seems to worsen depression. Never have I been more depressed than when smoking daily. It's nothing but a crutch.

Charles Whitman received Valium, and he loved his Dexedrine. He brought along a goodly supply of Dexedrine when he climbed the clock tower at the University of Texas.

The Columbine kids were well-medicated. Remarkably, despite their prescriptions, they were yet to be diagnosed with any mental illness.

When you read about someone who committed crimes, or merely caused a police-involved disturbance, the media will often say that "they had a history of mental/behavioral issues", which means that they were likely taking psychotropic drugs at the time of the incident. Many people choose "suicide by cop" which has been notoriously easy to do.

The FDA still grudgingly labels a few drugs with the "homicidal ideations" spiel, but not as many as they used to.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#222

Post by zpeti »

ShivTheShiv wrote: post #216
zpeti wrote: post #193

Earlier quoted context omitted.

I agree with you, but what we are arguing about is how much, and when? Looking at how many people are medicating for mental health issues in the west (or world), I find it extremely unlikely this is because all these people have gone through therapy, exercise and diet and they have to take medication. No. It’s the easy route to some sort of medicated happiness, and it’s profitable, so everyone does it. But this many…

This particular drug is about post partum depression. Sleep deprived women, often functioning as milk machines, while experiencing major hormonal changes and possibly recovering from major abdominal surgery. These are not people “taking the easy route”. Save the bootstraps talk for other patients.

Sorry, but no. I have two children. I as a father probably had mild PPD, and so did my wife after our second child.

You know why my wife had PPD? Because being a mother is hard, and she also had a lot of unresolved anger and issues towards her own mother, and she was reminding herself of her own mother and causing quite a bit of anxiety. We were also at an extremely difficult part of our relationship, we basically hated each other for a year.

What did we do? We both went to therapy, and asked the hard questions about why this was happening, and how to resolve them. My wife spent 6 months in therapy and resolved the issues with her mother, and now she is happy with her own performance as a mother. We went to couples therapy, which was extremely hard, but after over a year, we are basically in love again, and we are STARTING to understand what patterns are causing our issues, and how to deal with them.

We took no medication. But we were on the road to depression, but decided to actually look behind WHY this was happening.

Popping pills of course is much easier. You don't need to face your demons, or your parent's demons.

The trouble is it is at crucial times in life like childbirth when these demons emerge. Yet hardly anyone wants to face them anymore. This is not mentally healthy. And what's even worse, you are very likely to pass on many of these issues to your children if they remain unresolved.

I know this is counter to 70% of what americans believe in, but it's the hard truth, and I think many people deep down know this is the truth, but it's just much easier to take pills and bury the fact that EVERYONE has mental issues that need resolving, without taking medication.

I'm not talking about the extreme cases btw. I know in some instances medication is necessary. But it is WAY overused, to get out of making hard choices.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#223

Post by NoZebra120vClip »

loeg wrote: post #67

A little surprised at how often they repeated "in adults." Is there any reason to believe this would be ineffective for teen mothers?

Dramatically increased chances of suicidal ideations and actions, when 25 years and under.

So, the opposite of "effective".

Re: FDA Approves First Oral Treatment for Postpartum Depression

#224

Post by rrrrrrrrrrrryan »

loeg wrote: post #67

A little surprised at how often they repeated "in adults." Is there any reason to believe this would be ineffective for teen mothers?

It just means they haven't done enough clinical trials with younger people. Getting FDA approval for pediatric use is more difficult (as it should be).

Eating fish a few times a week won't lower your IQ, but if you're pregnant, the mercury content could leave your child permanently mentally disabled. Still-developing bodies and minds can be much more sensitive and delicate than an adult. Just because a drug has been shown to be safe and effective for adults doesn't mean it will be equally safe and effective for children.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#225

Post by haldujai »

psychphysic wrote: post #218
haldujai wrote: post #212

Earlier quoted context omitted.

> People are rightly highly suspicious of Big Pharma. Absolutely, but that should only trigger scrutiny which in this case would provide several answers for why this is a good thing and not a BigPharma scam. > efficacy over older cheaper drugs (like Alprazolam and Zolpidem/Zopiclone). This drug, and the IV formulation it is based on (Zulresso), are not the same as and have different mechanisms from sedative-hypnotics…

I don't think we disagree the more arrows in a quiver the better. But the network meta analysis did not show zuranolone beating placebo due to wide effect size. I'm old enough to remember the studies in the 90s where we so the saw the same thing with benzos and TCAs and SSRIs. Alprazolam beats SSRI for depression with significant anxiety and insomnia with faster onset but treatment must be time limited. That's uncann…

> But the network meta analysis did not show zuranolone beating placebo due to wide effect size.

It did not, using 1 of the studies, but my optimism is that the drug it was based on (brexanolone) was significant and is unfortunately only available IV (so difficult to access and expensive), so the hope is that this will play out similarly and why I feel is sufficient reason to give Big Pharma the benefit of the doubt that this isn't purely a money making play.

> Alprazolam beats SSRI for depression with significant anxiety and insomnia with faster onset but treatment must be time limited.

Sure, for anxiety-predominant scenarios but as you're alluding to there are significant dependence and abuse risks and hence why they're used as adjuncts.

If this turns out to work in the same pathway but safer that would be a huge win. If it turns out to work in the same pathway but not safer than non-benzo sedatives then you're right it's a scam. With that said:

> That's uncanny to me esp as both are PAM for GabaA

My clinical pharmaceutical resource lists mechanism not fully known. This is getting outside of my comfort zone to comment on validity or fully understand but this editorial (citing for my own accessibility) suggests a different mechanism from benzodiazepines:

Antonoudiou et al. (6) offer key insights into the potential mechanisms of rapid affective switching following brexanolone treatment of postpartum depression, despite the use of male subjects for all the studies. The remarkable discoveries include the parallels in human and rodent brain network dynamics associated with depression that are responsive to GABAergic analogs of allopregnanolone, the role of δ-subunit–containing receptors in some of these effects in mice, and the lack of effect of benzodiazepines on the electroencephalographic network dynamics, consistent with the lack of antidepressant efficacy of these compounds.

https://www.sciencedirect.com/science/article/pii/S000632232...

Antonoudiou et al: https://www.sciencedirect.com/science/article/pii/S000632232...

Re: FDA Approves First Oral Treatment for Postpartum Depression

#227

Post by amanaplanacanal »

zpeti wrote: post #222
ShivTheShiv wrote: post #216

Earlier quoted context omitted.

This particular drug is about post partum depression. Sleep deprived women, often functioning as milk machines, while experiencing major hormonal changes and possibly recovering from major abdominal surgery. These are not people “taking the easy route”. Save the bootstraps talk for other patients.

Sorry, but no. I have two children. I as a father probably had mild PPD, and so did my wife after our second child. You know why my wife had PPD? Because being a mother is hard, and she also had a lot of unresolved anger and issues towards her own mother, and she was reminding herself of her own mother and causing quite a bit of anxiety. We were also at an extremely difficult part of our relationship, we basically ha…

The resources to send everybody to therapy simply don’t exist. There aren’t enough therapists, nor money to pay them, for what you are suggesting. People aren’t taking the easy way out, they are taking the only path available.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#228

Post by fastball »

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]

Although I agree that a different name for this type of depression could be useful in a medical context (as the root cause of post-partum depression is likely to be different in the father vs the mother, so the distinction does matter), "post-partum" as a modifier can clearly apply regardless of who is going through the "partum". e.g, the father is experiencing depression after the birth of his child, therefore "post-partum depression".

Edit: and as others have pointed out, a separate name is probably not needed as medically this is generally referred to as "post-partum paternal depression".

Re: FDA Approves First Oral Treatment for Postpartum Depression

#229

Post by sgift »

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…

> SSRIs don’t work for many people and we only found out 2-3 years ago.

If you only found out 2-3 years ago that SSRIs don't work for many people that's decidedly a you-problem. Psychiatry has known this for ages, which is one of the reasons that depression treatment is still tricky. You have to try what works for each person individually. And usually it's a combination of things.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#230

Post by senttoschool »

astrange wrote: post #210
throwaway2037 wrote: post #179

Earlier quoted context omitted.

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

Wikipedia has relatively recent sources, 2017. https://www.sciencedirect.com/science/article/abs/pii/S01650... > Additionally, prevalence was significantly higher in women from low and middle income countries compared to women from high income countries (OR 1.8, 95% CI 1.4–2.2). The overall pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4–12.5). https://en.wikipedia.org/wiki/Postpartum_de…

Are we assuming that low and middle income countries still live in villages?

For example, in Malaysia, most people no longer live in villages but it's counted as a middle income country.

Post reply on HN