Bringing new life into the world can also bring a whirlwind of emotions, including excitement, joy, and even exhaustion and frustration. This whirlwind is to be expected, but for the up to 20% of women who experience postpartum depression, the emotions can be debilitating and dangerous.
Postpartum depression causes feelings of intense sadness and worthlessness, making it difficult to care for and bond with your newborn. Mothers can find themselves withdrawing from life and loved ones and may even have thoughts of harming themselves or their children. Treatment options are available, but a landmark FDA approval in August of 2023 may put millions of suffering parents on a faster path to improvement.
Zuranolone is a recently approved, fast-acting pill that patients experiencing postpartum depression can take over the course of 14 days. Previously, options were limited to traditional antidepressant and an intravenous treatment called brexanolone, which can only be administered in the hospital. Traditional antidepressants may take up to two weeks before a patient notices a difference, and up to 6-8 weeks at a therapeutic dose before full effect. With zuranolone, patients may see an improvement in the first three days.
“This medication targets the physiology thought to cause postpartum depression, so it is different than many other treatment options out there,” says Dr. Priya Gopalan, Associate Professor of Psychiatrics and Obstetrics in the University of Pittsburgh’s Department of Psychiatry. “A pill is much more easily accessible, particularly in the weeks and months following childbirth, when hospital visits may be difficult for parents to manage.”
Dr. Meredith Spada, Assistant Professor in the University of Pittsburgh’s Department of Psychiatry, stated that potential side effects include sleepiness and sedation. Patients should not drive, operate machinery, or do other dangerous activities until at least 12 hours after taking each dose of the medication.
While a pill that can be taken at home is ideal, Dr. Gopalan mentions that the research is still in its early stages, so it may be some time before the public sees a meaningful roll out of the medication. “It will be exciting to see how the delivery of this medication takes shape,” added Dr. Spada. “Zuranolone has the potential to be prescribed not only by psychiatrists, but also obstetricians and primary care doctors.”
Dr. Gopalan notes, “As with most psychiatric prescriptions, zuranolone will likely work best in conjunction with behavioral health treatments such as psychotherapy, use of other medications, behavioral management, support groups, and self-care tools. Make sure to talk to your doctor about referrals, concerns, and which options could work best for you.”
Risk factors for postpartum depression include:
· Already having depression before or during your pregnancy
· Experiencing other stressors such as a traumatic delivery
· Not having much support from family or friends
· Having a sick or colicky baby
· Having other stressors such as financial stressors or unstable housing
Magee Pharmacy believes zuranolone will be widely available by the end of 2023 or early 2024. If you are having thoughts of harming yourself or your baby, call 988 to be connected to your local suicide prevention & crisis lifeline.
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