The antidepressant citalopram (Celexa) may improve the mental health of women with postpartum depression by helping repair stress-induced alterations in the brain’s nerve cell networks, researchers from Ohio State University report.
Postpartum depression is a subtype of depressive illness that appears in roughly 12 percent to 13 percent of all U.S. women in the aftermath of childbirth. Use of the antidepressant citalopram may substantially reduce the severity of the condition in large numbers of affected women. In a study presented in late 2014 to the Society for Neuroscience, a team of Ohio State researchers used laboratory experiments on rats to explore the reasons this medication produces beneficial results. The researchers concluded that citalopram may help offset stress-related damage in the brain’s ability to maintain effective communications networks.
Postpartum depression can appear as much as a year after a woman gives birth, the U.S. National Library of Medicine reports. However, most cases occur within a quarter-year timeframe after childbirth. As with other forms of depression, moderate-to-severe symptoms of postpartum depression may include emotions such as guilt or hopelessness, an unusually irritated or agitated mood, an unusually withdrawn mood, concentration problems, sleep disruptions or changes, appetite disruptions or changes, partial or complete loss of the ability to feel pleasure, bouts of anxiety and the onset of suicide-oriented thinking, planning or behavior. Symptoms specifically related to recent childbirth include fear of being alone with a newborn or infant, an inability to take adequate care of a newborn or infant, unusual concern or lack of concern about a newborn or infant’s well-being and prominently negative thoughts directed at a newborn or infant.
Possible underlying contributing factors in the onset of postpartum depression include the major hormone fluctuations associated with giving birth, physical changes associated with giving birth, sleeplessness, worry about the responsibilities of motherhood and post-pregnancy changes in a woman’s personal, social or work life. Population groups with heightened risks for developing the condition include teens/women who give birth before reaching age 20, women with a history of mood disorders (depression or bipolar disorder) or anxiety disorders, socioeconomically disadvantaged women, women with relatively poor social support networks and women exposed to serious stress while pregnant or while giving birth.
Citalopram is one example of a group of antidepressants known as SSRIs (selective serotonin reuptake inhibitors). All medications in this group achieve their basic treatment effects by increasing the brain and body’s supply of the chemical serotonin, which plays a critical role in the normal ability to regulate mood, as well as in the maintenance of a functional sleep/wake cycle. Available forms of citalopram include oral liquids and tablets. Doctors determine specific doses of the medication on a case-by-case basis. Use of citalopram is especially closely monitored in anyone under the age of 25, largely because people under this age have increased risks for suicidal thought and behavior while taking the medication.
How Does the Medication Work?
In the study presented to the Society for Neuroscience, the Ohio State University researchers mimicked the symptoms of postpartum depression in rats by exposing the animals to ongoing, highly stressful circumstances capable of triggering the rat equivalent of human depression. When they looked at an area of the brain in each animal called the pleasure center (also found in human beings), they determined that stress exposure had led to a substantial change in the structure of the nerve cells responsible for maintaining normal brain communication. In turn, this nerve cell alteration reduced the rats’ ability to adjust to changes in their surroundings and to exhibit signs of mental well-being.
Next, the researchers gave the rats doses of citalopram every day for three weeks. At the end of this time period, they found that the nerve cells inside the rats’ pleasure centers had recovered their normal structure. The researchers also found that the symptoms of postpartum-like depression had disappeared.
The study’s authors believe their findings help explain what happens in the brains of women who develop the symptoms of postpartum depression. They also believe their findings help explain why affected women who receive citalopram (or, possibly, other antidepressant medications classified as SSRIs) frequently experience a substantial reduction in their depression severity. In addition, the authors note the importance of addressing the effects of postpartum depression in the three-week timeframe normally required for citalopram and other SSRIs to produce any treatment benefit.