Women with mild to moderate postpartum depression were enrolled in this study in Tehran, Iran, the site of many botanical studies in the last few years. Women were ages 18-45 and were 4-12 weeks post childbirth. To be included in the study they had to have a score of 10 or more and 18 or less on the 17 item Hamilton Depression Rating Scale (HDRS) (an additional items 18-21 are used to further qualify the depression). A total of 68 women entered the study, and received either 15 mg of saffron (1.65-1.75 mg crocin/capsule), twice daily or 20 mg of fluoxetine, a common selective serotonin reuptake inhibitor (SSRI), for 6 weeks. Other therapies such as psychotropic drugs or behavior therapy were not permitted during the study. Symptoms of postpartum depression were assessed with the HDRS at baseline and then at the end of weeks 1,3 and 6. If a patient had a partial response, it was defined as having a 25-50% reduction in her HDRS score. A responder was defined as having a score of 50% or more reduction in the HDRS score. For those with total remission, they had to achieve a score of 7 or less.
At the end of the 6 weeks, 18.8% of the saffron group and 21.9% of the fluoxetine group were in remission, which is not statistically significant. Of the responders, the saffron group was 40.6% and 50% in the fluoxetine group, which again is not statistically significant. In total, all patients had at least a partial response. Two women from each group discontinued due to progressing from moderate to severe depression. There were more frequent headaches, dry mouth, daytime drowsiness, constipation and sweating in the fluoxetine group.
Commentary:
Postpartum depression is experienced by an estimate 10-15% of postpartum women. The standard of conventional medicine care included fluoxetine as a first line therapy, however remission rates are low and adverse effects are problematic. In other research, Saffron flowers, have improved depression and premenstrual symptoms. Since this study was a randomized, double-blind, controlled study comparing saffron with fluoxetine in the treatment of mild to moderate postpartum depression, and no placebo group, it is not clear what the absolute antidepressant of these therapies would be. Saffron is considered to be safe postpartum and with lactation.
A longer and larger study, with a placebo group added, would be important to confirm the full value of saffron in mild to moderate postpartum depression
Reference: Kashani L, Eslatmanesh S, Saedi N, et al. Comparison of saffron versus fluoxetine in treatment of mild to moderate postpartum depression: a double-blind, randomized clinical trial. Pharmacopsychiatry. March 2017;50(2):64-68.
