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Zurzuvae for postpartum depression: Here’s what to know

Zurzuvae for postpartum depression: Here’s what to know

Zurzuvae is the first oral medication approved by the FDA for the treatment of postpartum depression.

Reviewed by:
Divya Khosla, MD
|
View bio
June 6, 2024
Original source:

Key takeaways

  • Zurzuvae is a controlled substance that works on GABA-A receptors.
  • Side effects include somnolence, so it’s important to avoid dangerous activities when taking it.
  • Zurzuvae has a 14-day treatment course and may work faster than other antidepressants.
  • Without insurance coverage, you may pay a lot out of pocket for this medication.
In this article

If you’ve recently given birth and are feeling persistent sadness, anger, or worthlessness, you might be experiencing postpartum depression (PPD). In addition to the challenges of caring for and forming a bond with your new baby, PPD can present another hurdle for new mothers to overcome.

Postpartum depression is a common mental health condition, affecting 1 out of 7 new moms, and as of 2023, there’s finally an FDA-approved oral medication that’s specifically developed to treat it: Zurzuvae. The brand name for zuranolone, this drug is a major breakthrough in the maternal mental health space.  

Before Zurzuvae, the only options were traditional antidepressants or Zulresso (the brand name for brexanolone), which is administered through an IV at the hospital for 60 continuous hours. It also has limited access due to its high cost. Zurzuvae works similarly to Zulresso, but as an at-home oral medication, it’s much more convenient.

Here’s what you need to know about how Zurzuvae works, how quickly it relieves symptoms, side effects, and more.

How does Zurzuvae work?  

Although there are many contributing factors to someone developing postpartum depression, one major element is thought to be the intense hormonal changes a woman experiences after giving birth. For example, levels of the hormone progesterone can drop significantly after childbirth, and this decrease in progesterone can lead to decrease in a neurosteroid called allopregnanolone.  

The way Zurzuvae works, by affecting this brain steroid, is ideal for treating women with postpartum depression. Zuranolone, the active ingredient in Zurzuvae, is a synthetic version of allopregnanolone and it can help the GABA-A (gamma-aminobutyric acid) receptors work more effectively, leading to fewer depressive symptoms, improved mood, and even reduced anxiety.

Clinical trials show promising results for Zurzuvae, with participants experiencing significant rapid relief from postpartum depression symptoms as well as anxiety.  

How do you take Zurzuvae for postpartum depression?

Zurzuvae is an oral medication that you take once daily for 14 days straight. Your doctor will determine what the ideal dosage is for you based on how your symptoms respond to the drug and if you’re having any major side effects. According to the FDA, the recommended dose is 50mg daily at night or 40mg daily if you experience CNS (central nervous system) depressant side effects. More on that later.

Zurzuvae can be used alone or together with other medications and treatments, including traditional medications used to treat major depressive disorder like SSRIs (serotonin syndrome reuptake inhibitors). You can also always benefit by going to talk therapy on top of taking medication. Consider new mom or postpartum depression support groups to connect with people in the same shoes as you, too.

Learn more about postpartum depression medication.

How long does Zurzuvae take to work?

One of the most exciting things about this medication is how quickly it works. You may experience symptom relief as soon as three days after starting Zurzuvae. In some cases, significant improvement may take up to 15 days.  

Although you only take Zurzuvae for 14 days, the medication's antidepressant effects may last for up to four weeks following treatment.  

What are the side effects of Zurzuvae?

As with any medication, there is a risk of experiencing side effects.

Several common Zurzuvae side effects are likely due to cause impairment to your central nervous system:

  • Sleepiness  
  • Drowsiness (somnolence)
  • Diarrhea
  • Dizziness
  • Confusion
  • Slow thinking
  • Trouble walking

Other side effects may include:

  • Urinary tract infection (UTI)
  • Common cold  
  • Diarrhea

Due to these side effects, the FDA recommends waiting 12 hours after you take your daily dose of Zurzuvae to drive or do any other potentially dangerous activity to ensure your safety and that of others.

You should also avoid other CNS depressants (such as benzodiazepines, opioids, and alcohol) since they can lead to increased adverse effects, which can be dangerous. These are not the only possible drug interactions with Zurzuvae, so be sure to tell your doctor about all over-the-counter and prescription drugs and supplements so they can make sure Zurzuvae is safe for you.  

Additionally, Zurzuvae comes along with the risk of suicidal thoughts or behaviors. If you start to experience this, contact your doctor immediately.  

Before prescribing Zurzuvae, your doctor will discuss all potential risks and benefits. They’ll ask about existing health conditions and medications to make sure it’s the right fit for treating your postpartum depression.

How much does Zurzuvae cost?

The cost of Zurzuvae will depend on various factors, including whether your insurance covers it, how much your insurance covers, where you live, and the pharmacy you go to.  

Since this is a new drug, it isn’t widely covered by health insurance companies yet. As of 2023, only 17 insurance companies were providing some type of coverage for Zurzuvae. In some of these cases, there are specific qualifications you need to meet in order to qualify for insurance to cover it, such as being diagnosed with severe PPD only or trying another drug (such as an SSRI antidepressant) for four weeks before trying Zurzuvae.  

You will have to contact your insurance provider directly to check if they cover Zurzuvae and learn if you will need a prior authorization request to get coverage.  

If your insurance won’t cover Zurzuvae, the price tag is hefty. The current wholesale cost of the drug is $15,900 for the 14 days of treatment. You can also look into Zurzuvae’s Financial Assistance Program.

How do you get Zurzuvae?

You can only get Zurzuvae with a prescription from your doctor since it is a controlled substance. That means there may be state limits as to how much of the medication you can get and how often.

If you think you might have postpartum depression and you’re curious about Zurzuvae, set up an appointment with your OB/GYN, a psychiatrist, or both. Either type of medical professional can diagnose and treat PPD. However, keep in mind that some insurance companies require a psychiatrist to write the prescription.  

Seeking help for postpartum is so important. You don’t need to go through this alone, and you can feel better with the right treatment and support. Treatment can help reduce your symptoms, improve your mental health, and help you feel better equipped to care for and bond with your newborn.

If you’re looking for a psychiatrist, consider Talkiatry. We’re a national psychiatry practice that treats a variety of mental health conditions, including postpartum depression. We provide virtual, in-network services so you can get the care you need from home. To get started, complete our free online assessment to get matched with a psychiatrist.

FAQs

How does it differ from traditional antidepressants?

Traditional antidepressants like SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) target serotonin and/or norepinephrine, which are chemical messengers in the brain that play a role in depression. Rather than targeting serotonin or norepinephrine, Zurzuvae works on gamma-aminobutyric acid (GABA)-A receptors in the brain. Zurzuvae also may work more quickly than traditional antidepressants.  

Does Zurzuvae help with anxiety?

Yes, Zurzuvae may help treat anxiety that occurs alongside postpartum depression. Clinical research found that people who took the medication also reported a reduction in anxiety.  

Is Zurzuvae a controlled substance?

Yes. Because of zuranolone depressant effects, which can lead to misuse, Zurzuvae is classified as a controlled substance. If you have a history of substance abuse, your doctor will decide whether you should take Zurzuvae or another medication to help with postpartum depression.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Does Talkiatry take my insurance?

We're in network with major insurers, including:

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Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Divya Khosla, MD

Dr. Divya Khosla, MD, is a board certified Adult Psychiatrist and board eligible Child and Adolescent Psychiatrist. She received her undergraduate degree from Case Western Reserve University in Cleveland, Ohio, and her medical degree from Ross University, completing all of her clinicals in Maryland, D.C., and NYC. She completed her adult psychiatry residency at The Ohio State University in Columbus, Ohio. Then she returned to the east coast, where she completed her child and adolescent psychiatry fellowship at Nassau University Medical Center in East Meadow, New York.

Dr. Khosla has participated in a variety of innovative academic clinical research, and has presented research at annual national meetings of the American Psychiatric Association. Her robust clinical experience with varying demographics at different clinical sites around the country has allowed her to treat patients in an evidence-based way, tailoring treatment to an individual’s specific needs.

Although Dr. Khosla’s practice focuses on medication management, she also implements supportive therapy and motivational interviewing in sessions to allow for a more comprehensive approach to treatment. Her clinical interests include depression, bipolar disorder, anxiety disorders, post-traumatic stress disorder, panic disorder, and ADHD.

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