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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

#251

Post by pc86 »

marginalia_nu wrote: post #86
pc86 wrote: post #45

Earlier quoted context omitted.

The chemistry of your brain literally changes, so yes, it's an issue that pharmaceuticals can help with tremendously. I am often the first person to rail against overprescribing of medication, particularly psychiatric medication, but this is categorically a Good Thing. And nothing in the article suggests this is anywhere close to a "just take this pill" type of treatment. This is part of a holistic treatment plan. Al…

The brain is an electrochemical machine. Your brain chemistry changes when you're happy, hungry, sad, angry, bored, horny, sleeping; pretty much every human experience is mediated through brain chemistry changes.

And in any other machine when something breaks you fix it. If your rotator cuff gets torn you don't say "just stop having shoulder pain" or "shoulder is a natural part of the process of life and you have to deal with it," you go to a PT, maybe have surgery, maybe even take a pill or two.

If you think PPD (or any other form of depression) is "brain chemistry" on the same level and getting hungry or horny you grossly misunderstand what depression is at a fundamental level.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#252

Post by pc86 »

j45 wrote: post #117
sixo wrote: post #55

Earlier quoted context omitted.

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

Lots of people became parents suing pandemic lockdowns and didn’t really have a choice or say in surrounding support structures being available or possible.

Which is itself completely irrelevant because support structures or lack thereof don't have anything to do with PPD in any way. Plenty of people with amazing support in their family and community end up with crippling PPD. Plenty of people with zero support don't have the slightest bit of PPD. It's irrelevant.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#253

Post by linuxftw »

refurb wrote: post #132
linuxftw wrote: post #17

[flagged]

This is such a lazy comment and the fact that you didn't copy paste the paragraph that followed makes me think you have some agenda to push. "The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ZURZUVAE and any potential adverse effects on the breastfed child from ZURZUVAE or from the underlying maternal condition."

Obviously this bit is implied. But, they should have done the safety studies so people can make a fully informed decision. It seems very unlikely they're going to direct all people taking this to stop breastfeeding, because it's going to make it sound like a poison and people won't buy it. Got to put profits first, I guess.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#254

Post by linuxftw »

maxbond wrote: post #62
linuxftw wrote: post #39

Earlier quoted context omitted.

[flagged]

We are having regular threads on HN about how the FDA is not approving drugs fast enough and someone in our community is dying and cannot access the experimental drug that may have saved them. Example: https://news.ycombinator.com/item?id=36827438

I'm all for people having access to whatever they want. What I'm not for is the FDA fully approving something without a sufficient amount of testing.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#255

Post by rzmmm »

Caligatio wrote: post #215
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…

Without any data, I suspect the incidence rate of PPD is unaffected by social factors but having a support system definitely helps mitigate the effects on the family (i.e. more hands to help with the baby). Fortunately my family has never had to deal with it but it's definitely not some minor illness for people.

Quickly looking at the research, seems you are right. Like most diseases, it's interplay between genetics and environment.

Social support is less important risk factor, while factors like marital satisfaction and partner's depression are more important. For women, adverse events such as loss of a loved one, husband's loss of job or serious economical issues seem to be important too (Escriba-Aguir et al. 2010).

This is also quite concordant with the fact that PPD is more common in less developed countries, as mentioned in another comment.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#256

Post by caeril »

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

I haven't yet read the clinical trial results, but suicidal ideation has turned out to be a shockingly common side-effect of many other types of anti-depressants. The comment was unnecessarily inflammatory, but the concern is reasonable.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#257

Post by marginalia_nu »

pc86 wrote: post #251
marginalia_nu wrote: post #86

Earlier quoted context omitted.

The brain is an electrochemical machine. Your brain chemistry changes when you're happy, hungry, sad, angry, bored, horny, sleeping; pretty much every human experience is mediated through brain chemistry changes.

And in any other machine when something breaks you fix it. If your rotator cuff gets torn you don't say "just stop having shoulder pain" or "shoulder is a natural part of the process of life and you have to deal with it," you go to a PT, maybe have surgery, maybe even take a pill or two. If you think PPD (or any other form of depression) is "brain chemistry" on the same level and getting hungry or horny you grossly m…

Well it is and it isn't.

The serotonin imbalance hypothesis of depression, widespread as it is in popular culture, has actually been pretty thoroughly debunked at this point[1]. We know that SSRIs do have a therapeutic effect, but it seems their effect is oddly enough unrelated to serotonin levels.

What they seem to do is mask the depressive symptoms to the point where you're given a sporting chance to "behave" less depressed, which is what seems to be the most effective treatment. It's fairly analogous to how painkillers can cure back pain by permitting you to move around more.

Not acting like you're depressed is the real cure, which is of course very cruel, because as anyone who has had a depressive episode will attest to, just getting out of bed may be a struggle.

[1] https://www.nature.com/articles/s41380-022-01661-0

Re: FDA Approves First Oral Treatment for Postpartum Depression

#258

Post by seattle_spring »

concordDance wrote: post #207

Are people flagging comments they disagree with rather than downvoting them? I'm seeing a lot of flagged top level comments.

I don't see any flagged comments that aren't low-effort flamebait. Those are exactly what the "flag" feature is for.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#259

Post by ksenzee »

saagarjha wrote: post #118
gmerc wrote: post #109

Earlier quoted context omitted.

Only a man could write this.

It is generally rare that Hacker News comments make me physically cringe. This is, unfortunately, one of those times.

The fact that I’m a woman (who has given birth and had PPD, twice) gives it that extra je ne sais quoi.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#260

Post by loeg »

NoZebra120vClip wrote: post #223
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".

Uh, if you're reading off table 1 at section 5.3, that's across all chronically-administered SSRIs -- not this drug in particular. Zurzuvae was evaluated in much smaller clinical trials of 347 women 18-44 and as far as I can tell, did not have any incidences of discontinuance due to suicidal ideation.
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