What is the mechanism of action of this treatment?

Postpartum Depression (PPD) treatments often involve medications that modulate neurotransmitter activity, particularly serotonin and dopamine, to alleviate depressive symptoms. Selective serotonin reuptake inhibitors (SSRIs) increase serotonin levels in the brain, improving mood and emotional stability. Atypical antipsychotics like Quetiapine not only affect serotonin but also dopamine pathways, which can help manage both depressive and psychotic symptoms. This dual modulation is crucial for PPD patients as it addresses the complex interplay of mood and cognitive functions, potentially offering more comprehensive symptom relief.

What side effects are associated with this type of intervention?

Common treatments for postpartum depression, such as atypical antipsychotics like quetiapine, olanzapine, and risperidone, can cause side effects including somnolence, fatigue, weight gain, and metabolic changes. These medications may also lead to extrapyramidal symptoms. Antidepressants, particularly SSRIs like sertraline, are also used and can cause nausea, insomnia, and sexual dysfunction. It is important to discuss these potential side effects with a healthcare provider to determine the most appropriate treatment.

What prior FDA approvals exist?

The FDA has approved several treatments for postpartum depression, primarily focusing on antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Quetiapine, an atypical antipsychotic that modulates neurotransmitter activity, particularly serotonin and dopamine, is being studied for its potential effectiveness in treating postpartum depression. While Quetiapine itself is not yet FDA-approved specifically for postpartum depression, its use in related conditions like major depressive disorder and bipolar disorder suggests its potential utility. Other atypical antipsychotics with similar mechanisms may also be considered for off-label use in postpartum depression.

What other types of research exist?

Promising novel alternatives to Quetiapine for postpartum depression in 2024 include: 1) Brexanolone, which is specifically approved for postpartum depression and works as a GABA-A receptor modulator. 2) Esketamine, a nasal spray approved for treatment-resistant depression, which acts on the NMDA receptor. 3) Cariprazine, an atypical antipsychotic with partial agonist activity at dopamine D2/D3 receptors and serotonin 5-HT1A receptors, showing promise in bipolar depression. These alternatives offer different mechanisms of action and have shown efficacy in related depressive conditions.

← Back to Search

Atypical Antipsychotic

Quetiapine for Postpartum Depression

Phase 1

Recruiting

Led By Verinder Sharma, MB

Research Sponsored by Verinder Sharma

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Capable of providing informed consent

Have a DSM-5 diagnosis of MDD or BD I, BD II or other specified bipolar or related disorder with peripartum onset

Must not have

Receiving a psychotropic drug such a mood stabilizer, an antidepressant or a sedative/hypnotic

Have a physical illness that is a contraindication to the use of quetiapine, or who have a history of intolerance or nonresponse to quetiapine

Timeline

Screening 3 weeks

Treatment Varies

Follow Up 10 weeks

Awards & highlights

No Placebo-Only Group

Summary

This trial is testing quetiapine, a medication for mood disorders and sleep problems, on women with postpartum depression who don't respond well to typical antidepressants. The drug works by balancing brain chemicals to improve mood and sleep. Quetiapine has been used for treating schizophrenia, mood disorders, and sleep disturbances.

Who is the study for?

This trial is for outpatient women aged 18-45 who have given birth within the last 6 months and are experiencing postpartum depression, as indicated by specific scores on depression rating scales. They must be able to consent, communicate in English, and not be at high risk for suicide or currently receiving certain psychiatric treatments.

What is being tested?

The study is testing Quetiapine's safety and effectiveness in treating postpartum depression. It aims to determine how well mothers tolerate this medication, which is typically used for bipolar disorder and major depressive disorder.

What are the potential side effects?

Quetiapine can cause side effects such as drowsiness, dry mouth, dizziness, constipation, weight gain, blurred vision or restlessness. More serious side effects might include changes in mood or behavior.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

Select...

I am able to understand and agree to the study's procedures.

Select...

I have been diagnosed with major depression or bipolar disorder related to childbirth.

Select...

I am a woman aged between 18 and 45.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

Select...

I am currently taking medication for my mood, depression, or sleep.

Select...

I cannot take quetiapine due to a physical illness, intolerance, or it didn't work for me.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ 10 weeks

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~10 weeks

This trial's timeline: 3 weeks for screening, Varies for treatment, and 10 weeks for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Blood pressure

Body mass index

Fasting lipid panel test

+7 more

Secondary study objectives

Edinburgh Postnatal Depression Scale

Generalized Anxiety Disorder 7-item scale

Hamilton Depression Rating (HDRS) total score

+1 more

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

1Treatment groups

Experimental Treatment

Group I: QuetiapineExperimental Treatment1 Intervention

They will initially be given 25 mg of quetiapine per day. The dose may be increased by 25-50 mg per week, to a maximum dose of 150 mg per day by week 6 of the study.

Treatment

First Studied

Drug Approval Stage

How many patients have taken this drug

Quetiapine

2003

Completed Phase 4

~3220

0 / 5Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

Postpartum Depression (PPD) treatments often involve medications that modulate neurotransmitter activity, particularly serotonin and dopamine, to alleviate depressive symptoms. Selective serotonin reuptake inhibitors (SSRIs) increase serotonin levels in the brain, improving mood and emotional stability. Atypical antipsychotics like Quetiapine not only affect serotonin but also dopamine pathways, which can help manage both depressive and psychotic symptoms. This dual modulation is crucial for PPD patients as it addresses the complex interplay of mood and cognitive functions, potentially offering more comprehensive symptom relief.

8-OH-DPAT enhances dopamine D2-induced maternal disruption in rats.[Challenge abstinence-a case report and overview on therapy of alcohol dependence during pregnancy].