Postpartum depression is as devastating as it is misunderstood.
For decades, this serious disorder has been mistaken for "the baby blues," which affects up to 75% of new mothers but typically only lasts for a couple of weeks. However, postpartum depression (PPD) can persist for months or even years, making it difficult to bond with the baby, maintain relationships, and cope with daily life.
But a new tool has arrived with the FDA approval of Zuranolone, the first oral medication designed specifically to treat PPD. Unlike general antidepressant medicines, Zuranolone is a two-week, at-home treatment that can relieve symptoms for some within three days.
"Zuranolone expands the toolbox of treatments for people with postpartum depression. This will hopefully allow more people to be treated effectively and quickly," says Dr. Jeffery Iler, medical director of Behavioral Health at Gender Wellness OB/GYN at UR Medicine.
What is Postpartum Depression?
Postpartum depression is not a fleeting cloud of sadness; it's a serious mental health condition that can severely hinder a mother's relationship with the newborn and others. If left untreated, it can last for months or years and worsen over time.
Symptoms of PPD include:
- Lack of concentration
- Loss of interest in activities
- Mood swings
- Panic attacks
- Persistent depression
- Weight loss or weight gain
What Causes Postpartum Depression?
The causes of PPD are complex, ranging from hormonal fluctuations to emotional, psychological, and social factors. Following childbirth, hormone levels drop significantly within the body, possibly contributing to postpartum depression.
The stressors of motherhood, sleep deprivation, societal pressures, and biological changes can also contribute to the development of PPD. By targeting the underlying factors that trigger postpartum depression, this medication alleviates the symptoms and allows mothers to regain control over their mental well-being.
How the New PPD Pill Works
Zuranolone was developed to address the biological and chemical imbalances that play a role in postpartum depression, offering a more precise and effective treatment option.
This medication falls under the "neuro-active steroid" category, closely mimicking the effects of a naturally occurring hormone in the body known as allopregnanolone. Both Zuranolone and allopregnanolone work to enhance the impact of a chemical called gamma-aminobutyric acid (GABA) in the brain, which reduces anxiety and chronic pain.
What really sets Zuranolone apart is its unique mode of action, particularly its rapid onset of action. Dr. Iler says, "Studies involving Zuranolone show that a significant improvement in depression symptoms can be observed within the initial three days of treatment—a remarkable contrast to many other antidepressants, which typically require several weeks to yield similar benefits."
Does this Postpartum Depression Medication Have Side Effects?
During clinical trials, the most common side effects were:
- Nasopharyngitis (the common cold)
- Urinary tract infection
In some women, Zuranolone may cause suicidal thoughts and behavior, and for some pregnant women, fetal harm. It’s recommended that women take effective contraception while taking the mediation and for one week after taking it.
Looking Ahead: Breaking the Stigma and Promoting Awareness
According to Dr. Iler, postpartum depression has been stigmatized and overlooked, leaving mothers isolated.
But, there has been an increased focus on preventing postpartum depression in recent years. If depression is present, the clinician and patient should work together to decide what to do. Some options include:
- Monitoring the symptoms for a few weeks
- Starting psychotherapy
- Beginning an antidepressant medication
While Zuranolone is a significant step forward, it is crucial to recognize that it is just one part of the broader conversation surrounding maternal mental health. Breaking the stigma associated with PPD, raising awareness about its prevalence, and ensuring access to adequate support and resources remain essential components of comprehensive care.
Dr. Iler notes, "Our understanding of what happens to the brain in depression is partly related to what we know about how medicines treat depression. A new medicine like Zuranolone helps deepen our understanding of this common mental health disorder. This may lead to more treatments in the future."
Mental Health Emergency Services
If you have any concerns about your mood or thoughts of suicide, please talk to your healthcare clinician as soon as possible. Call 988 if you or someone you care about needs immediate help.