OVERVIEW

Staying Up to Date with Evolving Postpartum Depression Pathophysiology and Treatment Research is organized by CME Institute of Physicians Postgraduate Press, Inc. (PPP).

Activity opens: 08/08/2023
Activity expires: 08/31/2024

Program Description:
One in 7 women are impacted by perinatal depression (PND), and half of postpartum depression (PPD) cases begin during pregnancy but are not diagnosed until postpartum. Delayed diagnosis and treatment of PND lead to poor outcomes for both mother and child, and if untreated can be associated with low birth weight in infants, child neurodevelopmental delays, and behavioral differences. New understandings in the pathophysiology of depression and PND have led to the development of novel and emerging therapeutics that are changing the treatment paradigm for these disorders. In this video Drs Rubiahna L. Vaughn, MD, MPH, and Kristina M. Deligiannidis, MD, discuss the neurosteroid mechanism within these new hypotheses and the therapeutics that focus on this mechanism.

Neuroactive steroids (NAS) are metabolites of progesterone localized throughout the stress neurocircuit that regulate inhibition-excitation balance within neural networks and have important roles in the response to stress conditions. Due to vast fluctuations in progesterone in the peripartum and postpartum periods, large physiological shifts in the NAS progesterone metabolite allopregnanolone (ALLO) and changing GABAA receptors (GABAAR) and/or GABA and glutamate concentrations lead to the GABAergic system being compromised and therefore a dysfunctional affective state. It is hypothesized that ALLO acts on GABAAR to shift the network to a healthy state. Many NAS are GABA positive allosteric modulators and generate both phasic and tonic effects, creating a longer effect. Recently approved and several investigational synthetic ALLO drugs are showing promising results with faster onset and lasting effects and are changing the game with regard to the treatment of PPD and depression.

Learning Objectives:
After completing this educational activity, you should be able to:
• Examine the impact of delayed diagnosis on outcomes in PPD and best practices for management
• Explore pathophysiological mechanisms related to the expression of PPD symptoms
• Review clinical trial safety, efficacy, and dosing for current and emerging therapeutics for PPD