The first oral medication for postpartum depression (PPD) is now available by prescription to women who may need it. In its August 4 announcement, the U.S. Food and Drug Administration said it had approved zuranolone (brand name “Zurzuvae”) to treat the depression associated with childbirth and (sometimes) late-stage pregnancy.
Until now, postpartum depression could only be treated with an intravenous injection of the drug Zulresso, which required finding a healthcare facility that administered the IV medication. A more convenient option (in the form of zuranolone) could now mean quicker, more immediate intervention and treatment for PPD.
Postpartum depression is characterized by many of the same symptoms that define major depression and therefore can be serious and life-threatening. It also can impair healthy attachment between a mother and her newborn child, hampering a child’s physical and emotional development.
What Makes Zuranolone a Breakthrough?
Zuranolone is a breakthrough in treating PPD. Here are some reasons why.
A New Mode of Therapeutic Action
Zuranolone is not like other antidepressants, in terms of how it works. The drug blocks specific neurons to promote healthy levels of GABA, a feel-good neurotransmitter that modulates mood and sleep.
This mechanism of action is different from how other antidepressant medications like SSRIs, tricyclics and MAOIs achieve their therapeutic effects. These drugs typically work by increasing the availability of other feel-good neurotransmitters, especially serotonin, norepinephrine, and dopamine.
Rapid Relief of Depressive Symptoms
Whereas most traditional antidepressants take at least six weeks to kick in, clinical studies found that zuranolone began to noticeably relieve depressive symptoms as early as the third day of use; and, the drug is only prescribed for a total of two weeks, as opposed to the minimum of months that most standard antidepressants require.
Short Course of Treatment
Patients who received a 14-day course of zuranolone in clinical trials continued to experience improved symptoms four weeks after their last dose.
Less Side Effects
The side effects of zuranolone are also milder than those associated with other antidepressants, according to the FDA. The most common side effects were drowsiness, dizziness, diarrhea, fatigue, common cold symptoms, and urinary tract infection.
Zuranolone’s Application for Other Mental Health Issues?
As of now, zuranolone has only been approved to treat PPD; but scientists are investigating its use for insomnia and Parkinson’s and whether it might effectively treat mood disorders like major depressive disorder and bipolar disorder. Could zuranolone one day treat these conditions much more rapidly, within roughly the same timeframe that some antibiotics are prescribed? That remains to be seen.
Another unknown is how long the drug’s antidepressant effects will last. If they were observed four weeks after the last dose, will they persist beyond that four-week mark—and if so, for how long? Answers to these questions will help determine how and to what extent zuranolone can be a treatment for many others living with depression and related symptoms like insomnia. For now, its success at treating postpartum depression is very encouraging, especially for the one in eight women with symptoms of PPD.