Tuesday, May 18, 2010

Post Partum Depression MAO-A Binding

Postpartum depression is a common problem. Although having a new baby is an exciting time in life too many women suffer from depressive symptoms shortly after childbirth which may range from "postpartum blues" to serious and at times suicidal or psychotic depression. Postpartum depression not only affects the mother but also can impair the mother-infant bonding. Everything new we can learn about this distressing problem is very important. A new study recently published in the Archives of General Psychiatry helps provide some new information.

This was a very small study and just provides us a tantalizing clue to one of the processes that occur postpartum but is an intriguing idea that I know will be explored further. One of the things that we have known is that postpartum depression is likely linked to estrogen levels after childbirth. After the baby is born estrogen levels decrease 100- to 1000-fold. But what does this do to the brain? 15 healthy women who were 4 to 6 days postpartum were compared to 15 healthy women who were not post partum. All were non smoking and medication free. They underwent a neuroimaging procedure positron emission tomography (PET) that looked at levels of monoamine oxidase A (MAO-A) in different regions of the brain.

Monoamine oxidase A is a protein, an enzyme, that metabolizes serotonin, dopamine, and norepinephrine which are key neurotransmitters thought to influence mood. MAO-A essentially reduces the activity of these neurotransmitters. The researchers determined MAO density in a variety of brain regions and found that there was significantly elevated MAO-A density (43%) in all the brain areas looked at in women who were postpartum compared to those who were not. Now these were all healthy women. We don't know what the MAO-A density levels would be in those who actually have postpartum depression.

The researchers speculate that possibly nutritional supplements that replace the neurotransmitters may be helpful in preventing postpartum depression and are going to carry out a study to evaluate this. In addition it may be that group of antidepressants that are monoamine oxidase inhibitors may be particularly useful in treating depression in this group of women. We just don't know. But this work opens up a new line of investigation in this common disorder.

Thought for the day

"What is man that Thou are mindful of him?"

The Psalmistvv

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