Mass General Hospital

Harvard Medical School

Venlafaxine for Postpartum Depression

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

Cohen LS, Viguera AC, Bouffard SM, Nonacs RM, Morabito C, Collins MH, Ablon JS. Venlafaxine in the treatment of postpartum depression. J Clin Psychiatry. 2001 Aug;62(8):592-6.

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2 Responses to Venlafaxine for Postpartum Depression

  1. Dayle Hawthorne MD June 8, 2015 at 10:29 pm #

    I am primary care provider for mom3mos pp with ppd put on sertraline by her ob provider who complains of no improvement and migraines as side effect of sertraline 50 qd. Researching current treatment options. Increase dose or change drug. Should change of drug class be considered.

  2. MGH Center for Women's Mental Health June 10, 2015 at 3:49 pm #

    We can’t make recommendations for a particular patient without evaluating them; however, I can give you a sense of the approach we usually take. We usually start with SSRIs because they seem to work the best for both anxiety and depression and have been studied in breastfeeding women. If the first one does not work or is limited by side effects, we move to another SSRI. If a woman has used an antidepressant with good results in the past, that would be the one we would go to.

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