Dr. Chris Marx
“Postpartum depression has been in the shadows for so long. There have been no medications specifically targeting postpartum depression, and not a lot of research on what works in the forms of other therapies,” says Dr. Chris Marx, a psychiatrist and professor at Duke University and the Durham VA Medical Center.
“This drug raises levels of allopregnanolone, a naturally occurring chemical in the brain called a neurosteroid. Neurosteroids show tremendous therapeutic promise. Allopregnanolone could be a game-changer, not only for postpartum depression, but also for traumatic brain injury (TBI), schizophrenia, post-traumatic stress disorder (PTSD), pain, Alzheimer’s disease and other conditions for which new treatments are urgently needed,” she says.
“How allopregnanolone works in treating post-partum depression is not completely clear. In addition to acting at GABAA receptors in the brain, allopregnanolone also decreases inflammation, increases the production of new neurons, protects against stress, decreases pain, and enhances communication between neurons.”
“Research has shown that people with depression, TBI, pain, PTSD and Alzheimer’s disease have low levels of neurosteroids such as allopregnanolone. Restoring allopregnanolone levels could thus decrease symptoms. Once administered through an IV, this new drug only stays in the body for a few hours. At Duke and the Durham Veterans Affairs Medical Center, we are working on longer-acting formulations of allopregnanolone and other neurosteroids to enhance adherence and access to these promising treatments.”
Dr. Chris Marx is director of translational neuroscience and vice chair for faculty in the Department of Psychiatry and Behavioral Sciences at the Duke University School of Medicine.
Dr. Marla F. Wald
“There is tremendous stigma around postpartum depression for women. Many women experience great shame and feel inadequate as mothers if they struggle with depression at a time that is supposed to be joyous,” says Dr. Marla F. Wald, a psychiatrist and psychoanalyst at Duke.
“Because of this stigma, many women choose to not seek help and endure great suffering in silence. Postpartum depression affects 15 to 20 percent of the general population, and at least half of this group goes untreated. As more targeted treatments like this become available, more mothers are likely to seek and benefit from treatment.”
“One of the concerns raised about this treatment is that it interferes with a mother taking care of her baby while being hospitalized for the 60-hour infusion. In reality, a mother who has severe postpartum depression is already impaired in her ability to care for her baby.”
“Being able to get this treatment in a couple of days would allow the mother to quickly return to care for her baby. This is much faster than waiting for the onset of conventional antidepressants for two weeks or more. It allows the mother to be more physically and emotionally available and attuned to her baby, which we know is critical to infant and child development.”
Dr. Marla F. Wald is a psychiatrist and psychoanalyst at Duke who treats children, adolescents and adults and whose primary treatment and clinical research focus is perinatal mental health.