Ask Your Pharmacist

January 28, 2021
Q:

I had my first baby four months ago. My husband and I love him so much, but this last week I can’t stop crying. Is there prescription medication that will help?

A:

I got this question recently from new mum Aneleyse McLaughlin, who didn’t realize the sadness she was feeling was actually Postpartum Depression (PPD). She’s agreed to share her story in the hopes of helping others who may be in the same situation. I thank her for her courage and openness. This is an important topic to mark Bell Let’s Talk Day this week.

We’ll begin with these observations from Aneleyse:

“A few things I wish I had known about postpartum depression: First, how late it can come; I assumed it happened directly or soon after birth and if not then, then never. However, I was four months post-partum before I saw any symptoms. Second, I wish I had known how slowly it creeps up on you; one day I was just having a bad Friday. A few weeks later, I was casually thinking about driving my car off of the road for some quiet. Third, I didn’t realize how the signs and symptoms are so varied; what I am experiencing may be quite different from what another woman experiences. And fourth, how hard it is for some women to recognize the signs; my husband sat me down to discuss PPD and I whole-heartedly disagreed at first. I thought I was just having a bad month. I wish more people spoke openly about PPD. When I got diagnosed, I didn't know anyone who had PPD. Now that I've opened up about it, close to fifty women have spoken to me concerning their problems with PPD. It's difficult, but with medication and hard work on my end (exercise, meditation, nourishing myself properly, journaling, and talking about it - a lot), it will and already has gotten better.”

What I can tell you as a pharmacist:

PPD occurs in 10 to 15 of every 100 women. Symptoms include low mood, loss of pleasure, and feelings of guilt or worthlessness. These symptoms are more than the common “baby blues” that often occur during the early days after childbirth. PPD usually begins about one month after childbirth and may persist over a period of months unchecked. Without treatment, PPD can lead to a negative impact on you, your baby, and your family. We now understand that depression after the birth of a newborn doesn’t only affect women, it is also a condition suffered by men, and is known as Post Natal Depression (PND). Women with a history of depression or post-natal depression during a prior pregnancy are particularly at risk of PPD.

Medication therapy can help alleviate the symptoms of post-natal depression. The selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed class of medications to treat PPD. Although these medications are excreted in breast milk, they are considered safe to use while breastfeeding. The medication class is generally safe and well tolerated and has been proven effective to treat major depressive disorder in adults.

Medication treatment of PPD is not limited to this class of medications. Each antidepressant class, and indeed each individual antidepressant within a class, has particular characteristics.   The medications take time to work, although you may have improvements in some of the physical symptoms of sleep and appetite disturbances within one to two weeks. Feelings, mood, and level of anxiousness generally see improvement after taking medication appropriately for a minimum of four to six weeks.

Medication therapy is not the only component of treatment. Counselling from a licensed counsellor is an effective way to understand your feelings and work through them in a safe and non-judgmental environment. A new mum or dad may feel especially isolated during COVID-19. Many therapists have adapted during the pandemic and are more than willing to meet by telephone or by FaceTime. To find a licensed counsellor in your area, check out: https://cctnb.ca/  

I challenge new parents this January to talk to each other openly about their feelings, and to reach out for the advice of a pharmacist if you have particular questions about medication therapy options for PPD or PND. Pharmacists will work you, alongside your physician or nurse practitioner, to find the best medication therapy for you. 

Dr. Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Sharp’s Corner Drugstore in Sussex, New Brunswick. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.