Postpartum depression affects roughly 1 in 7 mothers — the most common complication of childbirth, and frequently the least treated. The standard pathway is SSRI medication (sertraline is most common) plus therapy, both of which work for many patients but take 4-6 weeks to produce meaningful response. For mothers struggling to function during those critical first months, the lag is the problem.
The 2019 FDA approval of brexanolone (Zulresso) was supposed to change this — a postpartum-specific medication with rapid onset. In practice, brexanolone requires a 60-hour clinic infusion, costs $34,000+ per course, and is rarely covered by insurance. Few mothers can take 2.5 days away from a newborn for inpatient treatment. The FDA-approved postpartum option exists in theory but is operationally inaccessible for most patients.
At-home ketamine therapy fills this gap for mothers in Florida who: haven't responded adequately to SSRIs after 4-6 weeks, can't wait 4-6 weeks for SSRIs to work given their current symptom severity, or don't qualify for inpatient brexanolone. Ketamine's 24-72 hour response window plus session-based protocol fits the realities of caring for a newborn in a way that the FDA-approved postpartum-specific treatment doesn't.