Estimated reading time: 6-7 minutes
They are part of a patient population that can fall through the cracks in the health care system. It is estimated that each year in the United States, more than 400,000 babies are born to people with depression.
Postpartum depression is often undiagnosed and untreated. Now, doctors are hoping that the Food and Drug Administration’s approval of a postpartum depression drug called Zuranolone (brand name Zuzuzufly) will increase awareness of this debilitating disease and provide more treatment options. There is.
“The approval of zuranolone is a very exciting development in the treatment of postpartum depression. It adds a new drug treatment option for patients who do not want to use traditional antidepressants,” he said. Dr. Lauren Gimbel.Provided by Gimbel obstetrics and gynecology care We serve patients at the University of Utah Health and are a leader in clinical obstetrics. Perinatal mental health Collaboration at U of U Health Huntsman Mental Health Institute.
In a study of Zuranolone conducted before FDA approval, patients with severe postpartum depression reported improved mood and less depression as early as 3 days after starting the medication. In fact, Gimbel said, “symptom improvement was seen approximately two weeks after starting the medication, and the effect was maintained through the 45 days of the study period.”
“For some patients, the main benefit of zuranolone may be that it works faster,” Gimbel said. Typically, antidepressants take him 2 to 4 weeks to show improvement in symptoms. Another novelty of Zuranolone is that this drug is prescribed for a period of two weeks instead of several months. This makes it easier for patients to follow instructions about how often and for how long to take their medication. It could also improve access, as long-term psychiatric treatment can be difficult to access nationwide.
A similar drug called brexanolone was approved by the FDA in 2019, but it required long-term intravenous administration, had side effects, and required additional monitoring through a Risk Evaluation and Mitigation Strategies (REMS) program. did. By comparison, trials of the oral drug zuranolone were well tolerated by patients who took the drug.
About 16.5% of Utah women who gave birth in 2021 reported experiencing symptoms of depression, according to data collected by the Centers for Disease Control (CDC). This compares to her national average of 12.7%.
When pregnant and postpartum women were included, even more, nearly 1 in 3 Utah women reported symptoms of depression or anxiety.
“The fact that Zuranolone was developed specifically for postpartum women highlights how prevalent this condition is and how important it is to develop accessible treatment options to help individuals feel better faster.” I think that speaks to what we’re doing,” Gimbel said.
Approval of Zuranolone could help dispel the stigma surrounding postpartum depression and start a stronger conversation about how new parents can support this important time in their lives and the lives of their babies and families. there is.
This is a time when specific changes occur in an individual’s physical and mental health.
“New parents aren’t sleeping. They’re not functioning the same way they did before they had a baby. The self-care strategies they used to use to control their moods are no longer in place due to lack of time. In addition, hormonal changes are unique to the postpartum period, Gimbel explained.
“We know that untreated perinatal mood and anxiety disorders have negative consequences for mothers, their partners, and their offspring; indeed, for the whole family as well. “It impacts quality, health care engagement, increased use of health services,” Gimbel said, “and increases in substance use, infant attachment difficulties, and long-term developmental risks.”
That’s why it’s important for mothers to talk about their mood and any symptoms of depression or anxiety that are affecting their ability to live. This discussion is especially important if she is thinking of harming herself or her baby. It also clarifies the path for each individual to choose a treatment method.
“We can talk about everything from conservative options, like improving your sleep and eating, getting outside, doing some exercise. We can also talk about treatment, and for some individuals, drug therapy. We can talk about therapy,” Gimbel said. The most effective treatment usually uses all of these strategies and uses a combination of therapies and medications.
Gimbel said the mother’s death is also at risk.
“Maternal suicide is the leading cause of maternal mortality (death) in the first year postpartum, and this has implications for both improving screening by obstetric providers and encouraging mothers to talk about postpartum depression and anxiety.” “Understand how patients are feeling and follow up with their health care provider if they have concerns so they can get the care they need.” ”
Medical experts suggest it could improve screening, diagnosis, and treatment of perinatal mood and anxiety disorders. This requires interdisciplinary collaboration, including obstetricians, psychiatrists, and behavioral health teams, as well as reducing stigma and cultural expectations and improving access to women, their families, and support systems. Many people think that it will be.
Zuranolone may not be the best option for everyone. Women who have been treated with other drugs in the past and had good responses may want to use drugs that are known to work instead of trying a new drug, such as zuranolone.
During the testing of zuranolone, the study did not include breastfeeding women. Therefore, at this time, “it is not known how much of the drug gets into breast milk, so it is recommended not to breastfeed while taking the drug,” Dr. Gimbel said. Zuranolone’s effects on maternal breast milk are just one of several areas Gimbel would like to see further research.
“Zranolone has only been studied for 45 days, so I hope that what they study next is the long-term response to zuranolone,” Gimbel said. “If you are treated with antidepressants and have a good outcome, we try to ensure that your mood remains stable for six to 12 months after it stabilizes. The likelihood of this decreases.”
Zuranolone was developed by Sage Therapeutics and manufactured in partnership with Biogen. It is expected to be available by the end of the year after undergoing the 90-day review required for drugs that affect the central nervous system. The companies have not yet announced the price of the tablets.
