Monday, February 26, 2024
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Postnatal Depression

New Drug Brings Hope

An In-depth Look at Postnatal Depression

Postnatal depression (PND) is a serious mental health issue that predominantly affects new mothers in the aftermath of childbirth. As a life-altering event, the arrival of a new baby often combines joy with a monumental change, potentially leading to significant stress, severe sleep deprivation, and an emotional roller-coaster ride. These factors can coalesce to trigger PND in certain women.


The symptoms associated with PND are multifaceted and can present differently across individuals. Common signs encompass a persistently low mood, marked difficulties in forming a bond with the newborn, an urge to withdraw from social contacts or uncontrolled bouts of crying. In particularly severe instances, mothers may experience distressing thoughts of self-harm or causing harm to the baby.


The triggers for PND can be traced to a mix of biological and emotional elements. For instance, hormonal imbalances, such as a rapid decline in progesterone levels following childbirth, can provoke PND. Alongside these physical factors, the psychological burden of nurturing a new life, coupled with societal pressure and personal expectations, could add to the emotional stress, further propelling the onset of PND.

10% Of Mothers Affected

A significant proportion of new mothers in the UK, up to eight out of 10, experience the ‘baby blues’, a term that describes a temporary feeling of sadness typically setting in a few days after delivery. However, PND is a more acute and enduring condition. If symptoms remain beyond the first week or escalate over time, it may suggest the presence of PND, a condition affecting approximately 10% of new mothers. 

Zurzuvae: An Innovative Leap in Postnatal Depression Treatment

The US Food and Drug Administration (FDA) recently greenlighted a revolutionary drug known as zuranolone. This approval heralds zuranolone as the pioneering FDA-approved oral medication specifically crafted to combat postpartum depression. The drug, marketed under the brand name Zurzuvae, is prescribed as a once-daily pill consumed over a 14-day course.

This novel therapeutic approach presents a marked departure from the previous front-line treatment, which involved a continuous 60-hour intravenous (IV) drip of the drug brexanolone. Despite its effectiveness, this treatment mode presented several practical challenges, primarily due to the necessity for a healthcare setting and a substantial time commitment from the patient. In contrast, zuranolone, as a home-administered oral medication, bypasses these obstacles, enhancing patient compliance and access to treatment.

Zuranolone, akin to its IV counterpart brexanolone, is a synthetic analog of allopregnanolone, a naturally occurring steroid in the body. Intriguingly, allopregnanolone levels experience a dramatic upswing during pregnancy, followed by a sudden drop post childbirth. This abrupt fluctuation is hypothesised to contribute to the development of PND. Thus, both brexanolone and zuranolone aim to reinstate allopregnanolone levels, potentially alleviating the symptoms of PND.

Dr Kristina Deligiannidis, from the Feinstein Institutes for Medical Research in New York, spearheaded clinical trials that validated the efficacy of zuranolone. A Phase 3 study conducted between 2017 and 2018 demonstrated that patients consuming zuranolone experienced notable reductions in their depressive symptoms as early as three days into treatment, and these benefits persisted for up to 45 days.

Despite the promising results, the FDA has issued warnings about potential side effects. Notably, zuranolone might impair a person’s ability to execute potentially dangerous tasks such as driving. Common side effects range from dizziness, fatigue, and common cold, to more serious concerns like inducing suicidal ideations and behaviours. Furthermore, zuranolone can potentially harm the fetus, necessitating the need for reliable contraception during the course of the treatment and a week thereafter.

Zuranolone: Paving the Way for a Brighter Future in PND Care

This significant advancement in PND treatment signifies a beacon of hope for many struggling with the condition. By providing a user-friendly, home-based treatment option, zuranolone represents a substantial stride forward in mental healthcare for new mothers, further underscoring the importance of ongoing research and development in this critical field.

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