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New Pill for Treating Postpartum Depression: What to Know

New parents are part of a patient population that can fall through the cracks in the medical care system. Every year In the United States, it is estimated that more than 400,000 babies are born to individuals who are depressed. 

Postpartum depression often goes undiagnosed and untreated. Now, doctors hope the Food and Drug Administration's (FDA) approval of a pill for postpartum depression called zuranolone (under the brand name Zurzuvae) could raise awareness and increase treatment options for this debilitating condition. 

"The approval of zuranolone is a very exciting development in the treatment of postpartum depression,” says Lauren Gimbel, MD, an assistant professor in the Department of Obstetrics and Gynecology and clinical obstetrical lead of perinatal mental health at University of Utah Health. “It adds another option for medication treatment for patients who don't want to use traditional antidepressants.” 

What is postpartum depression? 

Postpartum depression is feeling deep sadness following the birth of a child that lasts longer than two weeks. Individuals may feel down, depressed, guilty, irritable, or angry. They may show low interest in things they previously enjoyed, experience low energy, have thoughts of hurting themselves or others, or have changes to concentration, appetite, and sleep that affect their ability to function. It’s a common pregnancy complication that can impact both women and men. Symptoms of postpartum depression can interfere with daily life. 

According to the Centers for Disease Control and Prevention (CDC), about 1 in 8 women experience symptoms of depression following a live birth. 

What is the significance of a postpartum depression pill? 

While treatment options for postpartum depression are individualized and developed uniquely with a healthcare provider, zuranolone is the first FDA approved medication specifically developed for the treatment of postpartum depression. 

In studies of zuranolone, patients with severe postpartum depression reported an improvement in their mood and a reduction in their feelings of depression as early as three days after starting the medication.  

"For some patients, the main advantage of zuranolone may be that it works faster," Gimbel says. "The improvement in symptoms was seen around two weeks after starting the medication and maintained its effect up to the 45 days it was studied.” 

Typically, antidepressants can take two to four weeks to show improvement in symptoms. 

Another novelty to zuranolone is that the drug is prescribed for a two-week period rather than for months. This makes it easier for patients to comply with directions on how often and for how long to take the medication. It may also improve access as it can be challenging to obtain long-term psychiatric care across the nation. 

Are there any side effects? 

During testing of the oral medication zuranolone patients who took it experienced minimal side effects. The most common symptoms included dizziness, fatigue, drowsiness, and upset stomach. 

However, just like any medication, zuranolone might not be the best option for every individual. Women who have been treated with other medications in the past and responded well may want to use a medication they know worked instead of trying a new medication such as zuranolone. 

During testing of zuranolone, the studies did not include women who were breastfeeding. So, for now, the recommendation is not to breastfeed while taking the medication. That’s because it’s not yet known how much of the medication gets into breastmilk. Individuals should also take an effective form of contraception while taking the medication and for one week afterwards, as it is not known if it is safe to take while pregnant. 

Postpartum depression and mental health

The approval of zuranolone may help lift the stigma surrounding postpartum depression and start a stronger discussion about how to help new parents through this critical period in their lives and the lives of their babies and families. 

This is a period of unique changes in an individual's physical and mental health. 

"We know that untreated perinatal mood and anxiety disorders are associated with negative outcomes for the birthing individual, their partner, and for their offspring,” Gimbel says. “Untreated, it impacts quality of life, engagement with medical care, increased use of substances, difficulty with attachment to the infant, and long-term developmental risks."  

That's why it's important for mothers to talk about their moods and any depressive symptoms or anxieties that are affecting their ability to function. This discussion is especially critical if they have thoughts of hurting themselves or their baby. It also clears the way for each individual to make choices about their treatment. 

"The fact that zuranolone was developed specifically for postpartum individuals speaks to how prevalent the condition is and how important it is to develop treatment options that are more accessible to help individuals feel better sooner," Gimbel says.