Advancements in Postpartum Depression Management: A Narrative Review of Brexanolone and Zuranolone
by Adam M. Crouse, 2025 PharmD Candidate, Jordan J. Weber, 2025 PharmD Candidate, Megan E. Oliver, 2025 PharmD Candidate
Postpartum depression (PPD) is a serious mood disorder that negatively impacts many new mothers every year. Unfortunately, PPD, which can last weeks to months, may not resolve on its own and can negatively affect how a mother is able to care for herself or her new infant. Since PPD is considered understudied and underdiagnosed compared to other psychiatric disorders, specific PPD treatments have been lacking. Specific selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants (bupropion and mirtazapine) were previously the only recommended pharmacologic therapies, which can take up to 8 weeks to see full effects. However, two new medications, Zulresso (brexanolone, Sage Therapeutics, Inc.) and Zurzuvae (zuranolone, Biogen Inc.), are now commercially available with FDA approval to treat moderate –to severe PPD. Brexanolone and zuranolone exhibit unique mechanisms of action involving Gamma-Aminobutyric Acid (GABA) to treat PPD more quickly. Despite the availability of new therapy options, various patient-specific factors, adverse effects, and cost must be considered for each patient case.
Keywords: Postpartum Depression, Brexanolone, Zuranolone, Allopregnanolone
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2024 September/October Table of Contents
Postpartum depression (PPD) is a serious mood disorder that negatively impacts many new mothers every year. Unfortunately, PPD, which can last weeks to months, may not resolve on its own and can negatively affect how a mother is able to care for herself or her new infant. Since PPD is considered understudied and underdiagnosed compared to other psychiatric disorders, specific PPD treatments have been lacking. Specific selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants (bupropion and mirtazapine) were previously the only recommended pharmacologic therapies, which can take up to 8 weeks to see full effects. However, two new medications, Zulresso (brexanolone, Sage Therapeutics, Inc.) and Zurzuvae (zuranolone, Biogen Inc.), are now commercially available with FDA approval to treat moderate –to severe PPD. Brexanolone and zuranolone exhibit unique mechanisms of action involving Gamma-Aminobutyric Acid (GABA) to treat PPD more quickly. Despite the availability of new therapy options, various patient-specific factors, adverse effects, and cost must be considered for each patient case.
Keywords: Postpartum Depression, Brexanolone, Zuranolone, Allopregnanolone
Download PDF
2024 September/October Table of Contents