Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) sertraline, fluoxetine, and fluvoxamine for the treatment of this disorder. In a recent report, Cohen and colleagues have demonstrated the efficacy of venlafaxine for the treatment of PPD.
In this study, 15women with onset of major depression within 3 months of delivery received open treatment with venlafaxine using a flexible dosing scheme. Baseline scores on the Hamilton Rating Scale for Depression (HAM-D) were 26.1 and declined to 7.0 after 8 weeks of treatment. Twelve of 15 patients experienced remission of major depression (HAM-D score < 7) . Mean effective dosage was 162.5 mg/day. Venlafaxine was also effective for the treatment of anxiety symptoms. In general, venlafaxine was well tolerated.
Venlafaxine is an effective treatment for women with postpartum major depression and may be particularly useful for women with prominent anxiety symptoms. In this study, rapid onset of action was demonstrated, with clinical improvement noted at 2 weeks of treatment. Data on the use of venlafaxine in breastfeeding women is limited. Given the efficacy of this medication in postpartum women, more study in this area is clearly warranted.
Ruta Nonacs, MD PhD