New Postpartum Pill: What You Need to Know

Physicians who treat pregnant and postpartum women remain optimistic about a new postpartum depression pill that became available at the end of 2023. Vanessa Padilla, M.D., a consultation-liaison psychiatrist with expertise in women’s mental at the University of Miami Health System, says the hype is for good reason.

Zuranolone, marketed under the brand name “Zurzuvae,” is the first FDA-approved oral medication designed specifically for postpartum depression. It’s fast and effective, with recipients in clinical trials reporting relief in as early as three days, according to Dr. Padilla.

Compared to other treatments, the new pill for postpartum depression (PPD) is expected to be a game changer. “I think every psychiatrist wishes for treatment that can abort any symptom that is uncomfortable for a patient,” says Dr. Padilla. “This is very promising because postpartum depression is debilitating.”

PPD is the most common postpartum complication, affecting about half a million women in the U.S. each year.

How the new postpartum depression pill works

Zurzuvae is available as a once-daily 14-day treatment. But, patients on the new PPD pill may experience relief as early as day three. And depressive symptoms may be significantly reduced by day 14.

Other types of antidepressant medications can take up to 4-8 weeks to be effective, according to the American Psychiatric Association. That’s a long time to wait for relief, especially for new mothers and babies during those critical first weeks of bonding.

After giving birth, women experience a change in their levels of estrogen and progesterone. Zurzuvae is a synthetic neurosteroid related to allopregnanolone that helps regulate mood, says Dr. Padilla.

“What’s so promising is that it works fast to help bring a mom out of that state of depression so she can bond with her baby,” says Dr. Padilla.

Zurzuvae seems to benefit patients for about 45 days. Because PPD can last much longer than that, many patients will need to take additional medication. It is best to discuss with your healthcare providers – ob/gyn, primary care physician, and/or psychiatrist – which is the best treatment for you.  

The oral pill builds on a previous postpartum depression treatment, Brexanolone (Zulresso), which is delivered intravenously in a hospital setting. Although effective, receiving that medication means spending at least 60 hours in the hospital with an intravenous infusion. That treatment costs more, which limits access to care.

Are there side effects to the postpartum pill?

The most common side effects of Zurzuvae include drowsiness, dizziness, diarrhea, and urinary tract infection.

Is the postpartum pill safe for breastfeeding?

Because the postpartum pill is so new, there isn’t enough data to conclude whether or not it’s safe to use while breastfeeding since the medication passes into the breast milk. Your health care provider can help you assess the risks or benefits of breastfeeding while taking Zuranolone.

Dr. Padilla hopes the medication’s short period will encourage more women to seek mental health treatment.

Common ‘baby blues’ vs. postpartum depression

The postpartum period consists of a full year after giving birth. Most new parents experience a wide range of highs and lows in that time. It’s common to feel some stress, anxiety, and even sadness.

While most new moms experience some form of “baby blues” postpartum, far fewer develop postpartum depression. Up to 75% of new moms have some form of baby blues, according to NIH, while one in seven are diagnosed with postpartum depression.

Postpartum depression feels more pervasive than the typical baby blues. It can occur any time in the year after having a baby, but it typically starts around two weeks postpartum and peaks around two months after giving birth, says Dr. Padilla.

How to recognize the symptoms of postpartum depression

If you or a loved one may be experiencing postpartum depression, seek help. Symptoms range widely:

• fatigue
• withdrawal
• intrinsic sadness with no apparent reason 
• mood swings
• loss of emotional control
• anxiety
• racing thoughts
• lack of motivation
• difficulty connecting with your baby
• loss of appetite
• suicidal thoughts 

What still needs to happen to support mental health

Having effective treatment on the market is only the beginning of supporting new moms who experience PPD. Dr. Padilla outlines three steps to help support women with PPD.

Make treatment affordable

In order for Zurzuvae to make a difference to public health, all new mothers who are suffering from PPD and want to try this medication need access to it. Since its release, the drug’s sticker price has been the biggest barrier to patients receiving treatment. Currently, Zurzuvae costs $15,900 for the 14-day supply. Insurance companies, Medicare and Medicaid vary in their coverage of this new medication.

“There are so many barriers and social determinants of mental health. If we can treat any debilitating illness, everybody should be able to access it,” Dr. Padilla says.

Despite the expense, obstetricians, gynecologists, psychiatrists and primary care physicians wrote hundreds of prescriptions for the new PPD pill in the days following its release late last year.

Increase postpartum screening

Since PPD can occur anytime in the first year, every woman needs to be screened. More partners, family members, and communities must be educated about symptoms and when to seek help.

Dr. Padilla says a collaborative healthcare model is integral to getting new moms the care they need at the right time. Women are most likely screened by a primary doctor, midwife, or obstetrician. These providers can initiate treatment when mild to moderate symptoms are identified.

Reduce the stigma of postpartum depression

Finally, reducing stigma is critical to helping more women get help. PPD can come with intense shame from those who experience it. 

“We need to be comfortable with the uncomfortable idea that our brains get sick, and during periods of life, we may be more vulnerable to mental health disorders. As long as there is available treatment and access to it, we can recover,” says Dr. Padilla.

Get emergency help if needed. Women coping with severe depression or suicidal thoughts should call the 988 Suicide and Crisis Lifeline. Postpartum Support International is another resource dedicated to helping families during the postpartum period through their helpline 1-800-944-4773.

Written by Wendy Margolin, a contributing writer to UHealth News. Updated in March 2024 by Dana Kantrowitz, contributing writer to UHealth’s news service.

Originally published on: October 12, 2023

Tags: depression treatment, new moms, symptoms of PPD, Vanessa L. Padilla