CNSPulse

NEW AND ANTICIPATED INTERVENTIONS FOR PERINATAL DEPRESSION

Anita Clayton — University of Virginia SOM

2026 ASCP Annual Meeting

The incidence of depression during the perinatal time-period is approximately 15% and is the leading contributor to maternal morbidity and mortality. If unrecognized or untreated, many women continue to experience symptoms for 3-5 years, continuing the negative impact on mother and child. Currently SSRIs and SNRIs are first line treatments for perinatal depression, but these medications are frequently underdosed or ineffective and patients and families are concerned about their use during pregnancy or lactation. During this panel, presentations will: 1) describe the incidence of symptoms and the potential pathophysiology of perinatal depression, 2) address the potential for epigenetic biomarkers to identify who is at risk for postpartum depression (PPD) and who is likely to respond to conventional antidepressants, 3) describe current approved treatments for PPD [Neuroactive steroid (NAS) GABA-A receptor positive allosteric modulators (PAMs)], and the promise of psilocin for PPD, and 4) describe the comorbidity of PPD and substance use disorders (SUD) and the acceptance and unrealized effectiveness of neuromodulatory interventions (TMS) in pregnant women. We hope a robust audience discussion about these issues will further our understanding of the state and future interventions in perinatal depression.

Learning Objective 1: Articulate unmet needs in perinatal depression such as early identification and intervention, management of co-morbid substance abuse, and potential response to treatments with new MOAs.

Learning Objective 2: Understand the potential promise of epigenetic biomarkers that identify who is at risk of PPD, will ilkely to respond to treatment with standard of care antidepressants, or indicate risk of postpartum psychosis; treatments with unique MOAs such as neuroactive steroid GABA-A receptor positive allosteric modulators and/or psychedelics like psilocin (5-HT 2A agonist); and neuromodulation in management of co-morbid substance abuse in pregnancy.

References

  1. Dama MH, et al. Perinatal Depression: A Guide to Detection and Management in Primary Care. J Am Board Fam Med. 2024;36(6):1071-1086 2. Wisner KL, et al. Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women with Screen-Positive Depression Findings. JAMA Psychiatry. 2013;70(5):490-498