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Notes on Women's Health
Notes on Women's Health

FDA Approves First-Ever Postpartum Depression Drug

Postpartum Depression DrugLearn the Facts about Postpartum Depression and this New Medication

The Centers for Disease Control and Prevention (CDC) reports that approximately 20 percent of new mothers are affected by some degree of postpartum depression. While treatments for postpartum depression have long been available, there has never been a drug specifically intended to address this potentially serious condition — until now. The approval of brexanolone (brand name Zulesso) by the Food and Drug Administration (FDA) represents a promising step forward for women suffering from postpartum depression and offers new hope for both them and their loved ones.

Read on for more detailed information on postpartum depression as well as the possible benefits and side-effects of taking Zulesso.

What is Postpartum Depression?

A woman’s body undergoes profound hormonal changes during pregnancy and for some time after delivery. These changes have well-known physical effects, but they can also have a psychological impact. Many women can experience depressive symptoms during pregnancy and after childbirth, a condition colloquially known as “baby blues.” Postpartum depression is the medical term for this occurrence which has some some common symptoms, including: anxiety, irritability, mood swings, sleep difficulties, unexplained sadness, lethargy, and loss of appetite. Postpartum depression typically appears soon after childbirth, around three to four days after delivery, but its onset may be delayed for months. This feeling is a normal part of childbirth, but if it lasts for longer and does not go away within 10 days after delivery, it may be time to speak with your doctor.

Postpartum depression not only affects the mother, but it can also hinder maternal bonding with the newborn. This condition is often accompanied by intense feelings of guilt. New mothers may feel that they are responsible for their depression and are “insufficiently maternal.” In reality, postpartum depression is caused by biochemical factors such as shifts in hormones and neurotransmitter levels.

Treatments Before Zulesso

Before the arrival of Zulesso, a drug intended for moderate to severe postpartum depression, treatments for postpartum depression mainly consisted of generalized antidepressant medications and psychological counseling. Although these treatments were often helpful, there were several drawbacks to the pharmaceutical use. For example, antidepressant therapy can often take several weeks before producing noticeable results. Also, some antidepressant medications cannot be used by women who are breastfeeding.

How is Zulesso Different?

One of the primary benefits of Zulesso over pre-existing medication is its rapid action. As reported by the American College of Obstetricians and Gynecologists (ACOG), women taking Zulesso showed improvement in their depression symptoms as soon as 48 hours after initiating treatment. This brief onset of action could be greatly beneficial to women experiencing postpartum depression soon after the birth of their child, as successful treatment could allow them to begin bonding with their infant earlier than was previously possible.

Unlike most other antidepressant medications, Zulesso acts on the gamma-aminobutyric acid (GABA) system in the brain. The GABA system is largely responsible for mediating stress responses like fear and anxiety. According to Dr. Kristina Deligiannidis, lead researcher on the Zulesso clinical trials, the stress response system does not act normally in women experiencing postpartum depression. Since Zulesso inhibits this system, it is specifically intended to treat postpartum depression.

Potential Drawbacks and Risks

Zulesso seems promising, but there are some considerations to think about before taking this new drug. First, Zulesso is not currently available as an oral medication. It must be received through an intravenous (IV) infusion, and this infusion cannot be performed at home. Women receiving Zulesso must have their infusion in a clinic under medical supervision. The infusion time is lengthy. While Zulesso begins to act rapidly, the total infusion time is 60 hours or two-and-a-half days.

This means a woman must spend over two days away from her home. Additionally, breastfeeding must cease for seven days after a new mother receives Zulesso. These restrictions may place a burden on women experiencing postpartum depression and cause some OB-GYNs to doubt that the drug will become a first-choice treatment for the condition.   

There are also some reported side-effects that may occur with Zulesso. These include headaches, dizziness, and insomnia. Loss of consciousness was a rarely-experienced side effect, and this possible occurrence is one reason for the required medical monitoring during Zulesso infusion.

Postpartum depression is a recognized medical condition that your OBGYN can help you treat. You should always let your OB-GYN know if you experience anxiety, depression, listlessness, or any other symptoms during your pregnancy or after your delivery. If you have any questions regarding postpartum depression treatment, you can contact Dr. Garofalo here.

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About the Connecticut OBGYN Practice

Dr. John Garofalo, M.D., is a CT OBGYN based in Fairfield County, providing care for Norwalk, Darien, New Canaan, Weston, Rowaytan and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.

For more information, go to www.garofaloobygn.com. John Garofalo, MD, and Laury Berkwitt, APRN, can be reached for personal consultations and well woman exams by calling 203.803.1098.