Zuranolone (Zurzuvae) for Treatment of Severe Postpartum Depression in Adults

CLINICAL QUESTION

How effective is the gamma-aminobutyric acid type A (GABA-A) receptor modulator zuranolone (Zurzuvae) for treatment of severe postpartum depression in adults?

EVIDENCE-BASED ANSWER

Zuranolone is an effective treatment for adults with severe postpartum depression. (Strength of Recommendation: A, meta-analysis of randomized controlled trials [RCTs].)

EVIDENCE SUMMARY

A 2023 systematic review and meta-analysis evaluated nine double-blind RCTs assessing the effectiveness and safety of GABA-A receptor modulators such as zuranolone in female patients with major depressive disorder or postpartum depression (defined as major depression with onset within 4 weeks of delivery).¹ Of the nine studies, two assessed zuranolone for postpartum depression (N = 346). The studies examined changes in the Hamilton Depression Rating Scale (HAM-D) score (scoring range = 0–54; higher score indicates more severe depression) with a 14-day course of zuranolone. Secondary outcomes included a more than 50% reduction in HAM-D score (response) or HAM-D score ≤ 7 (remission) and were measured up to day 45.