12/11/2025
All the buzz is about the release of zuranolone, the 2nd postpartum drug and the first to be released in Canada. It's a 14-day pill treatment for rapid recovery from moderate to severe postpartum depression which can be a debilitating illness at a precious time for a Mom and her baby.
As a neuroactive steroid, this drug functions differently than antidepressants such as SSRIs. Instead of increasing serotonin (put simply), this drug is a synthetic version of allopregnanolone, the metabolite of progesterone. Estradiol, progesterone, and allopregnanolone fluctuate significantly during pregnancy and into the postpartum period, with significant declines occurring at delivery.
These hormonal shifts can result in an imbalance of chemicals in the brain and this drug helps to restore the balance but not by depleting hormones. Put more scientifically, this neuroactive steroid is a positive allosteric modulator of the GABA-A receptor and restores neurosteroid signaling pathways after it's impacted by the abrupt decline of allopregnanolone among other hormones.
We have more to learn about this treatment such as how long the effect lasts (studies showed a sustained effect up to 45 days but patients weren't followed beyond that time) and if breastfeeding will be feasible (preliminary data shows less than 1% of the mother's blood concentration transfers into breast milk in 14 women studied). Yet, despite the prevalence of this condition which impacts 1 in 5 mothers, this is one of the first drugs to target this condition specifically and it's being called a game changer. I'm hopeful that it will help change the landscape for the treatment of postpartum depression as well as be an option for treatment for those with anxiety and bipolar depression that onsets postpartum.
Thanks for the interview !
