Zuranolone is the first oral drug specifically designed for severe depression after childbirth, with relief that starts on Day 3 of a two-week regimen, according to clinical trial results. Standard antidepressants can take up to three months to show mood improvement in women whose symptoms may include thoughts of harming themselves or their baby.
Maternal health and mortality related to childbirth have slowly gained more attention in recent years. But gaps remain in supporting people trying to cope with the deep despair of postpartum depression, believed to be partly linked to hormonal changes that trigger an emotional response far beyond the "baby blues," for which medical treatment is not needed.
Improvement in symptoms lasted for 45 days after the first dose, the study says. An earlier trial, published in JAMA Psychiatry in 2021, showed that a 30-milligram dose of zuranolone also alleviated symptoms through the same period. Zuranolone is believed to target the brain's GABA receptors, which are part of a major signalling pathway responsible for stress and mood regulation. In doing so, it compensates for reduced levels of a naturally occurring neurosteroid that protects the brains of pregnant people and their fetuses from stress during pregnancy.
However, she was reluctant to try antidepressants because she feared "poisoning" her baby with her pumped breast milk. Her only other option was being admitted to hospital right away, something she also resisted as she worried about abandoning her daughter at home. Dr. Diane Francoeur, CEO of the Society of Obstetricians and Gynaecologists of Canada, said zuranolone will give some assurance to women who may fear prolonged use of existing antidepressants, but any drug should be used in combination with psychotherapy for severe postpartum depression.
However, most therapy is inaccessible because of the high cost and the long wait times, said Singla, also a senior scientist at the Centre for Addiction and Mental Health in Toronto.
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