Postpartum depression: A role for psychedelics?
This review (2022) makes the case for using psychedelics in the treatment of postpartum depression (PDD). The effects we see in other clinical trials with psychedelics may translate to PPD such as 'reconnection.' This effect in PPD, by fostering a sense of ‘reconnection’ for the mother, may allow for improved mood and maternal sensitivity towards the infant, which can positively impact maternal role gratification and the mother-infant relationship.
Abstract
Background
Postpartum depression (PPD) is a major public health concern and has, at its core, a sense of maternal ‘disconnection’ - from the self, the infant, and the support system. While PPD bears similarities with MDD, there is increasing evidence for its distinct nature, especially with the unique aspect of the mother-infant relationship. Current treatment modalities for PPD, largely based on those used in major depressive disorder (MDD), have low remission rates with emerging evidence for treatment resistance. It is, therefore, necessary to explore alternative avenues of treatment for PPD.
Objective
In this narrative review, we outline the potential therapeutic rationale for serotonergic psychedelics in the treatment of PPD, and highlight safety and pragmatic considerations for the use of psychedelics in the postpartum period.
Methods
We examined the available evidence for the treatment of PPD and the evidence for psychedelics in the treatment of MDD. We explored safety considerations in the use of psychedelics in the postpartum period.
Results
There is increasing evidence for safety, and encouraging signals for the efficacy, of psilocybin in the treatment of MDD. Psilocybin has been shown to catalyse a sense of ‘reconnection’ in participants with MDD. This effect in PPD, by fostering a sense of ‘reconnection’ for the mother, may allow for improved mood and maternal sensitivity towards the infant, which can positively impact maternal role gratification and the mother-infant relationship.
Conclusion
Psychedelic assisted therapy in PPD may have a positive effect on the mother-infant dyad and warrants further examination.
Research Summary of 'Postpartum depression: A role for psychedelics?'
Introduction
Jairaj and colleagues frame postpartum depression (PPD) as a common and consequential disorder that overlaps with major depressive disorder (MDD) but also shows distinct features, notably a disruption of the mother–infant relationship and a core experience of maternal 'disconnection'. They note that conventional treatments for PPD have limited evidence of efficacy and emerging treatment resistance; brexanolone is the only medication developed specifically for PPD but is costly, requires prolonged inpatient administration, and is not widely generalisable. Given these gaps, the authors argue for exploring treatments with novel mechanisms. This narrative review sets out to outline the therapeutic rationale for serotonergic psychedelics, principally psilocybin, in the treatment of PPD and to discuss safety and pragmatic considerations for use in the postpartum period. The review emphasises potential benefits for maternal mood and maternal sensitivity towards the infant, and calls for examination of safety and feasibility in breastfeeding women as a precursor to pilot clinical trials.
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Jairaj, C., & Rucker, J. J. (2022). Postpartum depression: A role for psychedelics?. Journal of Psychopharmacology, 36(8), 920-931. https://doi.org/10.1177/02698811221093793
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