7 ms·

Since every top level comment here is a borderline tire fire, let me be the first to say: This is great news. We need better treatments for PPD, which is real

Since every top level comment here is a borderline tire fire, let me be the first to say: This is great news. We need better treatments for PPD, which is real and very serious that can cause long term lasting effects in serious cases without treatment, and can sadly even be fatal. Quality of life has risen steeply over the past several decades but mothers still walk an unpaved road. It's deeply worrying the lack of support and proactive care new mothers receive from medical professionals, though it is getting better, just very slowly. I hope this helps many new families survive and thrive.

haldujai 3y ago
The only valid reaction to this news is "Wonderful, we have a new tool in the arsenal to treat a very difficult to treat and potentially serious illness." > It's deeply worrying the lack of support and proactive care new mothers receive from medical professionals, though it is getting better, just very slowly. Agree, I don't treat or interact with PPD patients in my professional practice but my closest friend is an OBGYN and we've had many discussions about this over the years. At least in most academic practices all patients are provided with education during the later stages of pregnancy and prior to discharge postpartum with typically one routine follow-up visit planned. It's better than when I was a medical student but it seems a significant gap still exists between that and transitioning back to the patient's primary care provider who also tend to be more heterogenous in availability and knowledgeability about PPD.
mtlmtlmtlmtl 3y ago
Thank you. I'll never understand why there's such a dominance of luddite thinking, bad takes and conspiracy theories on HN, when it comes to the topic of mental health. Especially when it comes to drug treatments. Psychiatry no doubt has a lot of problems with it. But it's also the only game in town for a huge amount of people. What's the alternative? Prayer circles? Ayahuasca tourist traps? Cannabis? Homeopathy? Give me a break. Conventional medicine has always been imperfect, and has always improved over time. That's no less true of psychiatry than any other subfield. Whatever "alternative" therapies are truly effective tend to be incorporated into it eventually. In psychiatry we've seen this with meditation, and we're seeing it now with psychedelics.
- afavour 3y ago
  > I'll never understand why there's such a dominance of luddite thinking, bad takes and conspiracy theories on HN, when it comes to the topic of mental health I imagine there are many professional forums filled with people who know topic X inside out therefore assume they must also be an authority on unrelated topics Y and Z. But I also suspect there’s something about software engineering, perhaps the ability to succeed despite being deeply antisocial, or being very male dominated that means women’s mental health in particular is always going to be a dumpster fire discussion topic.
  - haldujai 3y ago
    It's insane to me that a group of educated and seemingly intelligent people seem to think they understand more about drug safety and prescribing than the FDA, researchers and physicians. This is reminiscent of the Texas district judge who decided to controversially overrule the FDA on a medication safety decision that recently made the news, not good company one wants to have and I'm hoping is coincidental than suggestive of similar biases.
    - warbeforepeace 3y ago
      Its easy to figure out. Religion causes it.
      - specialist 3y ago
        I no longer believe that's the root, or even the primary, cause. I keep thinking about Michael Crichton. He transmorphed from reality-based to nutter. What happened? Religion wasn't a factor. So what radicalized him? Historian Joanna Radin's theory, paraphrasing, is that Crichton's full faith and trust in The System was so completely shattered, by the Vietnam War and other outrages, that he completely flipped. The Speculative Present - How Michael Crichton Colonized the Future of Science and Technology https://www.journals.uchicago.edu/doi/epdf/10.1086/704047 https://www.journals.uchicago.edu/doi/epdf/10.1086/704047 The theme of the second season of Jill Lepore's The Last Archive podcast is about skepticism ("What fed Doubt?") S01E06 "It Came From Outer Space" includes the example of Crichton's radicalization. https://www.thelastarchive.com/season-2-episodes https://www.thelastarchive.com/season-2-episodes Lepore has completely opened up my mind about anti-science, conspiracy, and other social pathogens. Made me a bit more empathetic. Highest recommendation.
lettergram 3y ago
It is / was common enough for women to have their placentas ground up and consumed via a pill. It is supposed to help regulate the hormones I can imagine something like this doing something similar.
- khazhoux 3y ago
  Common? Citation (and barfbag) needed!
  - haldujai 3y ago
    It's shockingly true. I don't think any solid numbers are available on how common it is, but it at least appears to be relatively common in out of hospital births (and is becoming a trend). > This relatively modern phenomenon is practiced predominantly by white, middle class, married women in the global North, and has grown rapidly since the 1970s > Whilst prevalence is difficult to estimate, placentophagy is known to be practiced in North America, Oceania and Europe, plus parts of Latin America, the Middle East and Asia and is apparently growing in popularity. In a 2018 study of a medical records dataset for births outside of hospitals containing 23,242 birth events in the United States, 30.8% of mothers consumed their placenta. From 2009 to 2015 Google searches for “placenta encapsulation” increased 100-fold. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-2824-3 https://bmcpregnancychildbirth.biomedcentral.com/articles/10...
- haldujai 3y ago
  It's claimed to but it's worth noting that supportive evidence doesn't exist, small albeit possibly underpowered RCTs suggests it does not and there are potential harms in doing so. This review article provides an overview for the curious. https://www.sciencedirect.com/science/article/pii/S0002937817309638?casa_token=KmJnF7NAaCAAAAAA:8ooKjLevMnfJdiTU-f6az5I66rR7hcBZs6JHDvtROqS1qL0Y4Vg_udxs8ZAdl1kP4M77aSRH#sec3 https://www.sciencedirect.com/science/article/pii/S000293781...
psychphysic 3y ago
> We need better treatments for PPD It was compared to placebo. People are rightly highly suspicious of Big Pharma. I like the idea of a novel class but I won't pay attention to this new, expensive drug until it proves significant efficacy over older cheaper drugs (like Alprazolam and Zolpidem/Zopiclone). Technically it's a Z-drug (like Zolpidem/Ambien) which are non-benzodiazapine positive allosteric modulators of GABA_A However, since it's a neurosteroid most will probably not think of it as such. (It's name does begin with Z though... And end in -one like a steroid).[Note below] Anyways, it's licensed for 2 weeks only, side effects are drowsiness, sleepiness and cognitive impairment. You mustn't drive within 12 hours of a dose. It's best effects are where the depression is associated with insomnia and anxiety. It was compared to placebo not Alprazolam (Xanax) which has some antidepressant activity. That's just how you seek market Auth when nothing else is licensed. That's just smart. But you have a GABA agonist you must only use for the short term with primary anxiolytic and hypnotic effects. That will be widely used because otherwise you need off license script and will likely put even more people on the path to SSRI. [0] this is a reckless insightless cognitive impairment think Roseanne Bar racist tweet.
- haldujai 3y ago
  > People are rightly highly suspicious of Big Pharma. Absolutely, but that should only trigger scrutiny which in this case would provide several answers for why this is a good thing and not a BigPharma scam. > efficacy over older cheaper drugs (like Alprazolam and Zolpidem/Zopiclone). This drug, and the IV formulation it is based on (Zulresso), are not the same as and have different mechanisms from sedative-hypnotics which as an aside are not indicated as monotherapy for PPD (or any depression, don't give a downer to someone down). The mainstay of treatment is SSRIs. This class (which is the only FDA approved drug class for PPD) is an analogue of the endogenously produced metabolite of progesterone and the mechanism is not fully understood. To your point of head to head trials, you are correct they do not exist at this time and will eventually be done however all of these are still new. What we have right now are indirect comparative analyses which while limited show stronger magnitude effects than SSRIs. https://www.frontiersin.org/articles/10.3389/fphar.2022.950004/full#B2 https://www.frontiersin.org/articles/10.3389/fphar.2022.9500...
slim 3y ago
actually, where I live people used to live in multi-generational homes, where first time mothers had already had the chance to be trained on maternity from a young age by watching their sisters, wives of their brothers, sisters of their parents etc... also by having a chance of taking care of children younger than them including babies, all of this being group activities where girls get to collaborate, so highly educative. I'd argue parenting and maternity was not a problem in that lost society (although there were other problems)

haldujai 3y ago

The only valid reaction to this news is "Wonderful, we have a new tool in the arsenal to treat a very difficult to treat and potentially serious illness." > It's deeply worrying the lack of support and proactive care new mothers receive from medical professionals, though it is getting better, just very slowly. Agree, I don't treat or interact with PPD patients in my professional practice but my closest friend is an OBGYN and we've had many discussions about this over the years. At least in most academic practices all patients are provided with education during the later stages of pregnancy and prior to discharge postpartum with typically one routine follow-up visit planned. It's better than when I was a medical student but it seems a significant gap still exists between that and transitioning back to the patient's primary care provider who also tend to be more heterogenous in availability and knowledgeability about PPD.

mtlmtlmtlmtl 3y ago

Thank you. I'll never understand why there's such a dominance of luddite thinking, bad takes and conspiracy theories on HN, when it comes to the topic of mental health. Especially when it comes to drug treatments. Psychiatry no doubt has a lot of problems with it. But it's also the only game in town for a huge amount of people. What's the alternative? Prayer circles? Ayahuasca tourist traps? Cannabis? Homeopathy? Give me a break. Conventional medicine has always been imperfect, and has always improved over time. That's no less true of psychiatry than any other subfield. Whatever "alternative" therapies are truly effective tend to be incorporated into it eventually. In psychiatry we've seen this with meditation, and we're seeing it now with psychedelics.

afavour 3y ago
> I'll never understand why there's such a dominance of luddite thinking, bad takes and conspiracy theories on HN, when it comes to the topic of mental health I imagine there are many professional forums filled with people who know topic X inside out therefore assume they must also be an authority on unrelated topics Y and Z. But I also suspect there’s something about software engineering, perhaps the ability to succeed despite being deeply antisocial, or being very male dominated that means women’s mental health in particular is always going to be a dumpster fire discussion topic.
- haldujai 3y ago
  It's insane to me that a group of educated and seemingly intelligent people seem to think they understand more about drug safety and prescribing than the FDA, researchers and physicians. This is reminiscent of the Texas district judge who decided to controversially overrule the FDA on a medication safety decision that recently made the news, not good company one wants to have and I'm hoping is coincidental than suggestive of similar biases.
  - warbeforepeace 3y ago
    Its easy to figure out. Religion causes it.
    - specialist 3y ago
      I no longer believe that's the root, or even the primary, cause. I keep thinking about Michael Crichton. He transmorphed from reality-based to nutter. What happened? Religion wasn't a factor. So what radicalized him? Historian Joanna Radin's theory, paraphrasing, is that Crichton's full faith and trust in The System was so completely shattered, by the Vietnam War and other outrages, that he completely flipped. The Speculative Present - How Michael Crichton Colonized the Future of Science and Technology https://www.journals.uchicago.edu/doi/epdf/10.1086/704047 https://www.journals.uchicago.edu/doi/epdf/10.1086/704047 The theme of the second season of Jill Lepore's The Last Archive podcast is about skepticism ("What fed Doubt?") S01E06 "It Came From Outer Space" includes the example of Crichton's radicalization. https://www.thelastarchive.com/season-2-episodes https://www.thelastarchive.com/season-2-episodes Lepore has completely opened up my mind about anti-science, conspiracy, and other social pathogens. Made me a bit more empathetic. Highest recommendation.

lettergram 3y ago

It is / was common enough for women to have their placentas ground up and consumed via a pill. It is supposed to help regulate the hormones I can imagine something like this doing something similar.

khazhoux 3y ago
Common? Citation (and barfbag) needed!
- haldujai 3y ago
  It's shockingly true. I don't think any solid numbers are available on how common it is, but it at least appears to be relatively common in out of hospital births (and is becoming a trend). > This relatively modern phenomenon is practiced predominantly by white, middle class, married women in the global North, and has grown rapidly since the 1970s > Whilst prevalence is difficult to estimate, placentophagy is known to be practiced in North America, Oceania and Europe, plus parts of Latin America, the Middle East and Asia and is apparently growing in popularity. In a 2018 study of a medical records dataset for births outside of hospitals containing 23,242 birth events in the United States, 30.8% of mothers consumed their placenta. From 2009 to 2015 Google searches for “placenta encapsulation” increased 100-fold. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-2824-3 https://bmcpregnancychildbirth.biomedcentral.com/articles/10...
haldujai 3y ago
It's claimed to but it's worth noting that supportive evidence doesn't exist, small albeit possibly underpowered RCTs suggests it does not and there are potential harms in doing so. This review article provides an overview for the curious. https://www.sciencedirect.com/science/article/pii/S0002937817309638?casa_token=KmJnF7NAaCAAAAAA:8ooKjLevMnfJdiTU-f6az5I66rR7hcBZs6JHDvtROqS1qL0Y4Vg_udxs8ZAdl1kP4M77aSRH#sec3 https://www.sciencedirect.com/science/article/pii/S000293781...

psychphysic 3y ago

> We need better treatments for PPD It was compared to placebo. People are rightly highly suspicious of Big Pharma. I like the idea of a novel class but I won't pay attention to this new, expensive drug until it proves significant efficacy over older cheaper drugs (like Alprazolam and Zolpidem/Zopiclone). Technically it's a Z-drug (like Zolpidem/Ambien) which are non-benzodiazapine positive allosteric modulators of GABA_A However, since it's a neurosteroid most will probably not think of it as such. (It's name does begin with Z though... And end in -one like a steroid).[Note below] Anyways, it's licensed for 2 weeks only, side effects are drowsiness, sleepiness and cognitive impairment. You mustn't drive within 12 hours of a dose. It's best effects are where the depression is associated with insomnia and anxiety. It was compared to placebo not Alprazolam (Xanax) which has some antidepressant activity. That's just how you seek market Auth when nothing else is licensed. That's just smart. But you have a GABA agonist you must only use for the short term with primary anxiolytic and hypnotic effects. That will be widely used because otherwise you need off license script and will likely put even more people on the path to SSRI. [0] this is a reckless insightless cognitive impairment think Roseanne Bar racist tweet.

haldujai 3y ago
> People are rightly highly suspicious of Big Pharma. Absolutely, but that should only trigger scrutiny which in this case would provide several answers for why this is a good thing and not a BigPharma scam. > efficacy over older cheaper drugs (like Alprazolam and Zolpidem/Zopiclone). This drug, and the IV formulation it is based on (Zulresso), are not the same as and have different mechanisms from sedative-hypnotics which as an aside are not indicated as monotherapy for PPD (or any depression, don't give a downer to someone down). The mainstay of treatment is SSRIs. This class (which is the only FDA approved drug class for PPD) is an analogue of the endogenously produced metabolite of progesterone and the mechanism is not fully understood. To your point of head to head trials, you are correct they do not exist at this time and will eventually be done however all of these are still new. What we have right now are indirect comparative analyses which while limited show stronger magnitude effects than SSRIs. https://www.frontiersin.org/articles/10.3389/fphar.2022.950004/full#B2 https://www.frontiersin.org/articles/10.3389/fphar.2022.9500...

slim 3y ago

actually, where I live people used to live in multi-generational homes, where first time mothers had already had the chance to be trained on maternity from a young age by watching their sisters, wives of their brothers, sisters of their parents etc... also by having a chance of taking care of children younger than them including babies, all of this being group activities where girls get to collaborate, so highly educative. I'd argue parenting and maternity was not a problem in that lost society (although there were other problems)