https://orcid.org/0000-0002-9896-6094
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Abstract
Postpartum depression has deleterious effects on childbearing persons globally. Existing treatments have been largely extrapolated from those for other forms of depression and have included pharmacotherapy, psychotherapy, and neuromodulation. Hormonal treatments with oestrogen and progestogens, thought to be a rational approach to treatment in response to an emerging literature on the pathophysiology of postpartum depression, have only limited evidence for efficacy to date. Novel antidepressant development with allopregnanolone analogues, in contrast, has proven a promising avenue for the development of rationally designed and efficacious treatments. This state-of-the-art review presents the evidence for the current standard-of-care pharmacotherapy, hormonal treatment, and emerging allopregnanolone analogues for the treatment of postpartum depression along with a discussion of the current understanding of its neuroactive steroid-driven pathophysiology.
Acknowledgements
Dr. Deligiannidis’s effort for manuscript development and writing was supported by NIH R01-MH120313. The authors gratefully acknowledge Ibtihal Kamal for her work in creating of the manuscript.
Authors’ contribution
Dr Deligiannidis serves as a consultant to Sage Therapeutics, Brii Biosciences, Gerbera Therapeutics, GH Research, Neuroscience Software and Reunion Neuroscience. Dr. Deligiannidis served as a study principal investigator for contracted research awarded to the Feinstein Institutes for Medical Research from Sage Therapeutics, Nesos Corporation, Woebot Health and Premier Healthcare. She also receives grants from the NIH and royalties from an NIH employee invention.
Disclosurestatement
Dr. Carlini has no financial disclosures. No potential conflict of interest was reported by the author(s).