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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

#191

Post by themitigating »

mtlmtlmtlmtl wrote: post #150
xyzzy_plugh wrote: post #142

Since every top level comment here is a borderline tire fire, let me be the first to say: This is great news. We need better treatments for PPD, which is real and very serious that can cause long term lasting effects in serious cases without treatment, and can sadly even be fatal. Quality of life has risen steeply over the past several decades but mothers still walk an unpaved road. It's deeply worrying the lack of s…

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…

The compartmentilzation of intelligence

Re: FDA Approves First Oral Treatment for Postpartum Depression

#192

Post by psychphysic »

fnord77 wrote: post #49

why is this drug specific to PP depression? Would it work for typical, general depression in both sexes?

It's effects are likely best in short term depression related to anxiety and insomnia. PPD is just usually that type.

The biggest factor is that this stuff is basically a Z-drug like Zolpidem/Ambien and so treatment is time limited.

That makes it harder to use with MDD.

At the same time it did not conduct comparative studies to TCA, SSRI or other modern antidepressants.

"Treatment as usual" would likely be a short course of Z-drug.

If a man went to the doctor and said I've lost my dad and I'm low, anxious and can't sleep one would imagine this would work. We don't know if it would work better than an antidepressant, or sedative because no comparison was done.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#193

Post by zpeti »

mtlmtlmtlmtl wrote: post #177
zpeti wrote: post #165

Earlier quoted context omitted.

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…

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 people shouldn’t be doing it. They shouldn’t be taking the easy route, because it’s not dealing with many issues we should be dealing with, as society and as individuals.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#194

Post by aaronbrethorst »

haldujai wrote: post #188
aaronbrethorst wrote: post #168

I don't normally like to talk about matters this personal in a forum like this—especially given that I use my real name as my username here, but if it ends up helping one person then I think it'll be worth it. My son was born a little over 9 months ago. He's healthy, delightful, and utterly normal—and yet I, his father, still ended up with postpartum depression. I think it's underreported and under-appreciated that f…

I'm glad to hear you're feeling great having received treatment and that you're hopefully now getting to enjoy time with your healthy son. On a personal and professional level I'm greatly appreciative of your decision to share your experience and contribute to the destigmatization and increased awareness of male mental health despite anticipating attacks.

Thank you on both counts. And also for the detailed rebuttal you posted in the flagged reply below my original post.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#195

Post by pazimzadeh »

tptacek wrote: post #25
snvzz wrote: post #18

[flagged]

For 99.9999% of humanity's history, penicillin was "never needed". Antidepressant usage is universal throughout Europe. It makes more sense to treat postpartum depression, not less, because it's so likely to have a straightforward chemical cause. That's why there is an oral treatment specifically targeting it.

> For 99.9999% of humanity's history, penicillin was "never needed"

*pure penicillin https://en.wikipedia.org/wiki/Tocosh and they are not the only ones to do something like this.

I wonder why the American natives got so much sicker from European diseases than the Europeans did from the local native disease. It's almost like cities are petri dishes.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#196

Post by psychphysic »

Traubenfuchs wrote: post #162

Does a positive allosteric modulator of the GABAa receptor cause addiction the same way any old GABA agonist does? I love GABA agonists from benzos, benzo likes to phenibut and really wonder how it feels. If it feels the same way, then it feels like being wrapped in comfortable cotton, with all worries gone -heaven on earth. Hence the extreme addiction risk.

Note that benzos and Z-drugs are indeed positive allosteric modulators of GABA_A.

So one would assume so. The risks are reduced due to it being event related treatment (delivery) and time limited license (14days).

Alprazolam similarly has antidepressants effects and similar might work for PPD given its insomnia/anxiety predominant features.

FDA approved it based on placebo studies as there are no licensed pills for PPD. This is bag Sage/Biogen buckets of money.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#197

Post by haldujai »

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?

Good question, first thing to note is for FDA approvals adult is generally defined as 17 years of age.

For the lack of pediatric indication, it's almost certainly because the clinical trials used 18-45 as the inclusion criteria. This is typically done as it is (expectedly) easier to get Institutional Review Board ethics approvals for adults and considerably easier to recruit patients both simply because it's easier to recruit adults as well as the relative prevalence of adult PPD patients.

I'm not a psychiatrist but the similar intravenous drug this is based on (brexanolone) is approved at ages 15 and over so I don't expect there is any reason this would be ineffective.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#198

Post by habinero »

zpeti wrote: post #193
mtlmtlmtlmtl wrote: post #177

Earlier quoted context omitted.

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…

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…

It's not the "easy route". It's a route that _works_.

Saying it's "medicated happiness" is ridiculous fearmongering. Antidepressants do not make you happy. They do not change how you think or how you act. They can't. If you think they do, you do not know what you're talking about.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#199

Post by dna_polymerase »

gillytech wrote: post #182
maxbond wrote: post #79

Earlier quoted context omitted.

You've failed to demonstrate that this is authoritarian. And I haven't criticized you for criticizing the FDA. I've criticized you for defending your position with misinformation, and for deploying marginalized people as a smokescreen. If your best rebuttal is to put words in my mouth and frame my criticism as censorious, it's time to reevaluate. It's a form of motte-and-bailey argument, you've abandoned your positio…

Marginalized people? What are you talking about? The first cases of AIDS was identified in homosexuals. That's a fact. My position is not that there have been no breakthroughs in the treatment of HIV at all. My argument is that HIV does not cause AIDS. When you don't have empirical evidence to support your fake claim that HIV causes aids then yeah, you need to go authoritarian. Hence endless government and para-gover…

You used the r-word. You come here with claims that go against the status quo and provide zero evidence to support your claims.

Just admit it, you don't like gay people. No need for this idiotic 'AIDS is fake' charade.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#200

Post by psychphysic »

nemo44x wrote: post #15

> Use of Zurzuvae may cause suicidal thoughts and behavior. Zurzuvae may cause fetal harm. Might be better off just smoking a joint.

I dug into the FDA docs and relevant studies over the post few months.

As far as I can tell that warning might be just boilerplate for antidepressants these days.

Similarly for foetal harm it's on animal studies and they advice effective contraception for 1 week after last dose while they collect data.

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