Psychedelic therapy and postpartum depression: priorities and prospects

Approximately 15% of pregnant women experience postpartum depression (PPD). Even with currently available antidepressant treatments, many women will continue to be impaired by symptoms. Psychedelic therapy offers a promising transdiagnostic therapeutic strategy for several mental health disorders, and early results from current trials suggest that serotonergic psychedelics may represent a viable therapeutic approach for PPD. However, there is marked variability in the therapeutic response to psychedelic therapy, and the benefit-risk ratio in this population is not yet clear. To inform the rationale for the use of serotonergic psychedelics in the treatment of PPD, this review summarises the existing knowledge of immune, endocrine and neural pathways underpinning PPD and explores how serotonergic psychedelics interact with these pathways in the context of maternal motivation, bonding and caregiving behaviours. Finally, special considerations for psychedelic therapy in the postpartum period are outlined and future perspectives explored. Despite the rationale and encouraging early findings, further research is required to determine efficacy and safety profiles. Future studies, particularly longitudinal trials, should include adaptations and safeguards tailored to the unique physiological, psychological and caregiving contexts of the postpartum period.