Postpartum anxiety affects women who have recently had a baby or become a parent. It presents as severe anxiety with thoughts and emotions that are outside of an individual’s control, often taking over a woman’s thoughts.
Having a new baby in the family is bound to come with some concern, but postpartum anxiety is more intense than regular fear, all-consuming, with constant worry, irrational fear about things that may be vague and general, and a constant sense of danger.
Studies indicate that postpartum anxiety affects an average of 15% of women after giving birth. There is no single cause of postpartum anxiety, but it can be related to several things, including the following:
- Problems with sleep. Caring for a newborn baby is incredibly stressful and leads to severe sleep deprivation, especially with difficult sleep schedules for a new baby.
- Change in hormones. After delivery, there is a sharp decrease in female hormone levels, and this causes overreactions and mood problems, which is why postpartum anxiety often presents with postpartum depression.
- Stress. Certain milestones can trigger the development of postpartum anxiety, like a typical pregnancy or problems breastfeeding.
- Mental health. your history of mental health will put you at a higher risk for certain conditions. If, for example, you have a history of anxiety disorders, you are more likely to develop postpartum anxiety after giving birth.
So, what medication for postpartum depression and anxiety is available? What is the best medication for postpartum anxiety?
Postpartum Anxiety Medications
Medications for postpartum anxiety include a wide range of options, such as SSRIs, SNRIs, beta-blockers, and benzodiazepines. All of these can be used as part of a multidisciplinary approach to treatment, including things like support groups, lifestyle changes, and therapy.
Selective Serotonin Reuptake Inhibitors (SSRIs) for Postpartum Anxiety
The most common medication for postpartum anxiety, especially medication for postpartum depression and anxiety simultaneously, are selective serotonin reuptake inhibitors (SSRIs). These have been heavily researched and work by blocking the reabsorption of serotonin in the brain once it has been released.
Under normal circumstances, serotonin is created and released and then reabsorbed so it doesn’t linger. But depression and anxiety can often disrupt the amount of serotonin that is produced, diminishing it and, therefore, diminishing your mood. These might be the best medication for postpartum anxiety presenting with depression because they stop your brain from reabsorbing the serotonin, so it lingers much longer, leaving your mood elevated.
Some examples include:
- Fluoxetine
- Sertraline
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) for Anxiety
Another type of medication for postpartum anxiety is serotonin and norepinephrine reuptake inhibitors (SNRIs). These are very similar to SSRIs, and they can be used as a medication for postpartum depression and anxiety at the same time. These work a little bit differently by blocking not just the levels of Serotonin reabsorption but also the levels of norepinephrine reabsorption.
SNRIs work to selectively increase levels of both in order to find a good equilibrium. Some examples include:
- Effexor (venlafaxine)
- Cymbalta (duloxetine)
- Pristiq (desvenlafaxine)
Both of these are neurotransmitters that are responsible for regulating things like mood and sleep. These can help control the activity in your amygdala. The amygdala is the part of your brain responsible for forming emotions like fear. By controlling this part of the brain, you can reduce the amount of generalized fear you experience as your postpartum anxiety symptoms.
Benzodiazepines: When Are They Used?
Other medications for postpartum anxiety are benzodiazepines. Benzodiazepines are a common prescription medication specifically for anxiety disorders.
These work by increasing your GABA levels. GABA is a chemical that your brain naturally produces. It’s a neurotransmitter that reduces activity in the brain particularly in the areas responsible for your breathing, memory, emotions, and reasoning. It is available in over the counter doses that are much smaller, sold as a sleep aid for the same ability to calm the brain.
This medication causes not just calmness and sleepiness but drowsiness. It is often reserved for short-term use, like panic attacks, because of the side effects.
Beta-Blockers for Physical Symptoms of Anxiety
Beta-blockers are not approved by the FDA for anxiety treatment, but they can be prescribed off-label for physical symptoms of anxiety. Beta-blockers stop the effects of adrenaline and epinephrine on your beta receptors. Epinephrine is a neurotransmitter that helps initiate your fight or flight response in normal conditions, but if you are struggling with postpartum anxiety, it can increase the intense feelings of your anxiety symptoms, particularly your racing heart rate.
Beta-blockers can reduce the physical effects of anxiety by regulating your blood pressure. They are also much more fast-acting and work well for physical symptoms in particular.
Potential Side Effects and Considerations
There are potential side effects for each of the medications listed above.
SSRIs
With SSRIs, you can experience anxiety, agitation, and suicidal thoughts as some of the main symptoms of this antidepressant and anti-anxiety medication. Other potential side effects include the following:
- Insomnia, nightmares, or vivid dreams
- Constipation, diarrhea, nausea, or vomiting
- Sexual dysfunction
- Weight gain
- Sweating, joint pain, headaches, and dizziness
SNRIs
With this medication, you can typically expect common side effects that include excessive sweating, dry mouth, nausea, vomiting, fatigue, and headache. Other symptoms can include the following:
- Changes in appetite
- Increased blood pressure
- Insomnia
- Agitation
- Muscle weakness
- Tremors
Beta-blockers
One thing you need to consider is that beta blockers can be prescribed off-label for physical symptoms of anxiety, but they are not approved by the FDA for anxiety treatment as of yet. Beta-blockers are also not appropriate for anyone who has bronchial asthma or types of heart conditions. They do have possible side effects, including:
- Low blood pressure
- Gastrointestinal issues
- Skin reactions
- Allergies
Benzodiazepines
If you are considering benzodiazepines, you need to be aware that they are not suitable for people who have breathing problems, kidney disease, or lung disease.
More importantly, there are several side effects, including:
- Depression
- Dizziness
- Drowsiness
- Sedation
- Confusion
- Disorientation
- Problems breathing
- Loss of balance
- Amnesia
Some preliminary research explored the usefulness of benzodiazepines in large doses to help trauma victims with temporary amnesia such that their brains would not commit the traumatic memories to long-term storage and, therefore, they wouldn’t struggle with PTSD.
It is this same underlying concept that new mothers need to consider, as the several side effects associated with a benzodiazepine postpartum anxiety medication can present several risks to parents who are with their children alone. It may not be a medication you can take if you are trying to care for a child on your own because of the sedation, dizziness, and disorientation.
More importantly, benzodiazepines have a high risk of dependence and addiction associated with them.
There are also considerations you need to bear in mind.
Timing
One of the things you want to consider is how long it takes for your medication to become effective. Traditional antidepressants and anti-anxiety medications prescribed for postpartum anxiety medication purposes can take several months to be completely effective. For example, someone taking SNRIs might notice an improvement within two weeks, but the majority of the improvement won’t come for at least one or two months.
What does this mean for you as a new mother? It means you can’t expect immediate relief but you still have to stick with the regimen that’s prescribed by your doctor. It can take a while for neurological changes to go into effect so be patient with yourself and with your medication.
Breastfeeding
There may be considerations for the type of postpartum anxiety medication you are prescribed depending on whether or not you choose to breastfeed. Beta-blockers can be taken while breastfeeding, but only some SSRIs can be. Some SNRIs or SSRIs can get excreted into breast milk, so it’s something that has to be monitored.
Summing Up
Overall, you can find a lot of different options for postpartum anxiety medication. It’s important to consult with a healthcare provider to determine the best treatment plan based on your individual needs and health considerations, extending to medications with consideration for their potential side effects and whether or not you can use them while breastfeeding, as well as other lifestyle changes and modifications that can support the efficacy of your medication.