Postpartum depression medications: What to know

Up to 19% of new mothers experience a mental health condition called postpartum depression. This mental health condition is a form of depression that may involvesfrequent crying, irritability, mood swings, and feelings of being overwhelmed. It’s more severe than the baby blues (but not as intense as another rare but serious condition called postpartum psychosis). You may begin feeling symptoms of postpartum depression around one week after giving birth. However, women may be diagnosed at any time during the first year postpartum.

The good news is that postpartum depression is highly treatable. With therapy and medication, you’re likely to feel like yourself again in no time. In this article, we’ll discuss what medications commonly treat postpartum depression, how to get a prescription, and potential side effects.

What medications treat postpartum depression?

Doctors commonly prescribe several types of antidepressants to treat major depressive disorder. The same medications are frequently prescribed in an off-label capacity to treat anxiety disorders, mood disorders, and postpartum depression. Off-label uses are very common and safe. This designation simply means the FDA hasn’t approved the medication for that specific condition, although there is research to show its effectiveness.  

The most common types of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are a class of antidepressant medications that block neurons from reabsorbing serotonin—one of the brain’s chemicals responsible for mood regulation. This means there’s more serotonin available in your brain to regulate your mood and transmit messages between neurons. SSRis include Zoloft (sertraline) and Prozac (fluoxetine)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs block the reuptake of serotonin, just like SSRIs, but they also block the reuptake of norepinephrine—a chemical that helps control your attention and stress response.
• Atypical antidepressants: Atypical antidepressants are a group of antidepressant medications that can’t be categorized in another antidepressant class. They typically affect your brain chemistry similarly to SSRIs and SNRIs, although each one does something slightly different.

There are many different antidepressants your doctor may recommend based on your health history and symptoms. They may consider current FDA approved medications like Zurzurvae (zuranolone), the first FDA-approved oral medication for PPD. There’s also Zulresso, also known as Brexanolone, which has to be administered as an infusion in a hospital rather than at home. There may be barriers to accessing these medications including insurance coverage.

Here’s more on Zurzuvae, including how it works in detail on GABA and allopregnanolone,

Which postpartum medication is the best one for me?

Different medications and doses work for different people when it comes to depression, including the kind you might experience after giving birth. Your doctor will ask about your medical history, symptoms, and breastfeeding plans before prescribing the best medication for postpartum depression.  

Finding the right dose and medication sometimes takes a few tries, so don’t be discouraged if the first one doesn’t work how it should. Keep note of your symptoms and whether you begin feeling better a few weeks after starting a new medication. If not, your doctor can adjust your dose or help you find a new medicine to try.  

What are the side effects?

Antidepressants, like any medications, sometimes cause unwanted side effects. Don’t worry, most side effects are mild and temporary while your body adjusts. If they’re overwhelming or you experience an allergic reaction to your medicine, let your doctor know immediately.

Each postpartum depression medication has slightly different potential side effects, which your doctor will go over with you before prescribing any one of them. Here are some common ones that you may encounter.

Common side effects of antidepressants

• Decreased appetite, nausea, constipation, dry mouth
• Sedation, insomnia, dizziness
• Headaches
• Tremors, agitation, anxiety
• Sweating
• Low sex drive  

Severe side effects of antidepressants

• Serotonin syndrome
• Worsening depression and suicidal thoughts
• Activating mania
• Seizures

Zurzuvae comes with other side effects related to your central nervous system, like drowsiness.

How do you get postpartum depression medication?

The most common way to get mental health treatment, including medication, is through your current doctor or a psychiatrist. Here are the steps you’ll take to get a prescription.

Meet with your primary care doctor

The first step in treating your mental health concerns is working with your current doctor. Make an appointment with your OB/GYN or primary care physician—whoever is treating you during your postpartum period. Let them know how you’re feeling. Try to be as open and honest as possible during your conversation with them since they’ll likely provide a referral to a psychiatrist or may be able to prescribe your medication directly.

Get a referral for a psychiatrist

If your primary care doctor doesn’t prescribe your medication themselves, they’ll likely refer you to a psychiatrist to do so. Some insurance plans also require a referral before seeing a psychiatrist, so make sure to check your plan details. Here’s more on whether you need a referral to see a psychiatrist.

Complete an evaluation

Early in your treatment, your psychiatrist will likely schedule a diagnostic evaluation appointment with you. This is where you can explain your situation and symptoms, and they can confirm a PPD diagnosis and treatment plan.  

Not sure where to start when it comes to finding a psychiatrist? Meet Talkiatry. At Talkiatry, we can help you get a personalized treatment plan that may include medication, therapy, or both. We’re a national psychiatry practice that provides in-network, virtual care—and you can schedule a first visit within days. Get started with a short online assessment.

Begin treatment

Once your psychiatrist prescribes medication and you discuss a treatment plan, it’s time to get started! Monitor your symptoms as you begin medication and/or therapy. Your doctor may change your dose or the medication you’re taking based on your feedback. If any unpleasant side effects arise, make sure to tell your psychiatrist right away.  

Can you take medication for postpartum depression while breastfeeding?

Many antidepressants prescribed for postpartum depression are safe to take while breastfeeding. However, a small amount of your medication will likely transfer to the baby through your breast milk. This small amount is usually considered safe and isn’t a concern for the baby’s health. That said, it’s a good idea to talk to your psychiatrist and OB/GYN or PCP about the pros and cons of antidepressants before starting medication. They can inform you of any possible risks or specific medications to avoid when breastfeeding.

Can you treat postpartum depression without medication?

The decision to start medication is a personal one, and it’s not for everyone. That said, it’s important to know that help exists and that postpartum depression is treatable. Like major depression, PPD may last months, affect your quality of life, even interfering with your relationship with your new child.  

Medication isn’t the only way to treat postpartum depression. Implementing regular cognitive-behavioral therapy (CBT), support group sessions, and self-care practices are all great ways to improve your mental health. Make sure to work with your doctor to develop a treatment plan, and let them know whether or not you’re interested in taking medication.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.