Profiling zuranolone as a treatment option for postpartum depression

INTRODUCTION: Postpartum depression is defined as the occurrence of a major depressive episode in the four weeks after delivery; however, up to 50% of cases begin before delivery. First-line treatment for mild postpartum depression is psychotherapy, but patients with limited access to this kind of treatment or moderate to severe illness typically require pharmacotherapy. In general, selective serotonin reuptake inhibitors are considered first-line treatment options. However, the titration of these medications to a therapeutic dosage may take weeks. AREAS COVERED: In this review, the authors conducted a search of the available literature discussing the efficacy and safety of zuranolone, a fast-acting orally bioavailable synthetic neurosteroid that was developed for the treatment of postpartum depression. EXPERT OPINION: Zuranolone is a promising medication in the armamentarium of treatments for postpartum depression. However, evidence for long-term outcomes is limited due to the lack of comparative trials with other active treatments for postpartum depression and the exclusion of lactating populations or those with psychiatric comorbidities. More studies are needed to define the full scope of its clinical applicability.