Evaluating the Efficacy of Zuranolone for Postpartum Depression

Announcer:
You’re listening to Advances in Women’s Health on ReachMD. On this episode, we’ll hear from Dr. Elijah Salzer, who’s a Clinical Professor at the Pace University Lenox Hill Hospital PA Program in New York City and a staff physician assistant in gynecology at Eastchester Medical Associates in the Bronx. He’ll be sharing key findings from a study he co-authored, which evaluated the efficacy of zuranolone in patients with postpartum depression. Here’s Dr. Salzer now.

Dr. Salzer:
The objectives were to determine whether or not zuranolone was effective as a treatment, not only for postpartum depression, for which it was created, but also for major depressive disorder, and this was a systematic review as well as a meta-analysis. What wound up happening is that there were six studies that were ultimately evaluated, and they were all double-blinded, randomized controlled studies. Of those six studies, two were really evaluating the efficacy of zuranolone on treating postpartum depression. The other four were focused on treating major depressive disorder.  

One of the things that was used to determine the scores was an instrument called HAM-D. It’s the Hamilton Depression Rating Scale, which is used to determine how people are rated in terms of the diagnosis of major depressive disorder as opposed to HAM-A, which evaluates anxiety. And what was found was that there was evidence that zuranolone clinically significantly improved for patients with postpartum depression who had scores that were diagnostic for postpartum depression.

One of the issues with any kind of depressive condition for which people are seeking to treat pharmacologically is that it takes a long time for people to respond to these drugs. When you look at the selective serotonin reuptake inhibitors or the selective norepinephrine reuptake inhibitors, you start to see some improvements in a couple of weeks, but full improvement can take six to eight weeks, and that’s a long time for people to wait, especially when they’re new parents. The symptoms they’re having from postpartum depression, an exacerbation, or new onset of major depressive disorder can really impair their ability to function, to take pleasure in life, to care for a neonate—all of those things.

And the impressive thing about zuranolone is that not only is it the first oral drug ever developed for postpartum depression, but it can start being effective within two weeks, and that’s what was found with the systematic review when taken once a day, which I think is also important because it’s hard for most people to take a drug more than once a day. But when you have the pressure of caring for an infant and maybe other people in your household, that really is a burden for the patient, especially with somebody with depression.

It is also harder today to treat mental health disorders that are amenable to psychotherapy, like depression and anxiety, because it’s harder to find a therapist, leave home, or find the time to even meet with a therapist online. Having zuranolone, which was developed for this condition, is an enormous advancement.

I also think that having a drug that was specifically developed for this may well make patients feel more willing to treat the condition. I think whenever you’re dealing with a patient who has been pregnant and has any kind of disease associated with that pregnancy, there is an enormous amount of guilt that comes with such a condition, and having a drug that is formulated for a particular condition may alleviate those symptoms.

Announcer:
That was Dr. Elijah Salzer talking about the efficacy of zuranolone for postpartum depression. To access this and other episodes in our series, visit Advances in Women’s Health on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!