Dr Rachel Dalthorp: Addressing Barriers in Postpartum Depression Treatment


With an effective therapy available for treating postpartum depression, Rachel Dalthorp, MD, believes health care providers need to focus on educating patients and helping them navigate the health system so zuranolone can reach those who need it.

Zuranolone (Zurzuvae; Sage Therapeutics/Biogen), the first oral FDA-approved treatment for postpartum depression (PPD), hit the market in December, granting physicians and patients a more accessible option.

Rachel Dalthorp, MD, executive medical director of Specialty Services, LifeStance Health, explained to The American Journal of Managed Care® that access to zuranolone offers progress in addressing barriers for those seeking care for PPD.

This transcript has been lightly edited for clarity.


Does the recent availability of oral zuranolone mitigate any gaps in care for patients experiencing postpartum depression?

I think for me, as a psychiatrist, especially one that's seen the impact of these types of medicines on patients, it's frustrating that we're not seeing more women be treated, and there are a lot of reasons for that. But when you have such an innovative, really transformative medicine that's available, it's frustrating that we're not accessing it like we should be for moms. And I think there are a lot of reasons for that.

We still have a lot of stigma in mental health; we still have the perception that childbirth and becoming a mother is a beautiful, stress-free event, and if you struggle, there's something wrong with you. But I think that this medicine represents a talking point, which is that [PPD] is a very biologically-based illness. And when you talk to moms about hormones, many of them who experience PPD have a history of sensitivity to hormonal fluctuations. So, when you talk about this being a neurosteroid related to the hormone progesterone, they really start to understand the biological impact, right? And so, it takes away some of the stigma.

If we can educate society and moms and women who support moms and partners—if everyone starts talking about PPD, it decreases that stigma—we're going to be more open to admitting if we're struggling. So, that's one thing. The other thing that's really an issue is identifying it at the point where the patient is presenting and that's usually in the OB [obstetrics] office, and so, doing screening is something that we need to do a better job. It's getting better, but if we can identify that if we can decrease stigma, ask moms about it, and get them rapidly into treatment, that's when we're going to see the best outcomes for moms and families.

Our health care system is complicated. Often, patients have trouble navigating it, right? And so, I think that, as a health care provider, we all have to work together and advocate for access to care. This is the only FDA-approved medicine for PPD that's an oral medication. So, there's lots of work to do. We've got an effective treatment. We just need to educate and adapt that into our regular everyday practice for patients.

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