The FDA-Approved Medication Therapy for Postpartum Depression: What You Need to Know

Zulresso can work quickly and effectively.

mom holding newborn

Medically reviewed in July 2022

Updated on July 21, 2022

If you’ve just had a baby, you’re probably experiencing the juggling act that comes with it: recovering from delivery, struggling with breast or bottle feedings, changing diapers, learning to swaddle, and trying to squeeze in precious hours (or minutes) of sleep.

Some new parents manage the postpartum period without major issues. But many mothers struggle with intense sadness, feeling overwhelmed, and disinterest in their newborn. In fact, each year an estimated 600,000 to 900,000 new moms develop postpartum depression (PPD). When you have PPD, it means your depression lasts more than two weeks after childbirth and it affects both your daily activities and your ability to care for your infant.

In the past, many people with PPD who didn’t respond to lifestyle adjustments and talk therapy relied on oral antidepressants, which can take weeks to kick in. Then, in 2019, the U.S. Food & Drug Administration (FDA) approved Zulresso (brexanolone), the first—and still only—drug specifically meant to treat PPD.

The basics of Zulresso for PPD
Zulresso takes effect quickly—in some cases, within 24 hours—and maintains its effectiveness for up to 30 days after its administered. While it’s not entirely clear how Zulresso works, one theory is it reduces symptoms by helping the brain adjust to hormonal changes, such as the sudden drop in progesterone levels women experience right after giving birth.

Zulresso is administered through a 60-hour IV infusion. The drug is only available through a restricted program, known as the Zulresso Risk Evaluation and Mitigation Strategy (REMS). It must be administered by a healthcare provider (HCP) in a certified healthcare facility, specifically, a hospital or infusion clinic. During this time, you will be monitored for side effects, such as sudden loss of consciousness and excessive sedation. You will be able to see your baby during this time, but the newborn must be accompanied by another adult.

Zulresso is not for everyone
Most nonpregnant people with PPD are eligible for this treatment, but you should talk to your doctor about the risks and benefits if you:

  • Are breastfeeding or are planning to breastfeed
  • Drink alcohol
  • Have kidney problems or end-stage renal disease

It’s important to tell your HCP about any prescriptions (particularly other antidepressants), over-the-counter medications, vitamins, or supplements you’re taking prior to treatment. Also tell your HCP if you become pregnant again before receiving the drug, as it’s not known whether it will harm your fetus.

The high price of the drug may also be an issue. Insurance may cover some, or most, of the costs, and Zulresso’s maker, Sage Therapeutics, offers co-pay assistance programs if you have health insurance.

How to recognize PPD
It’s important to be aware of your individual risk factors for PPD. This could help you recognize the difference between PPD warning signs and normal postpartum anxiety linked to hormonal fluctuations and major life changes, also known as the “baby blues” or “postpartum blues.”

Some people are more susceptible than others to having PPD, including those who had a hard time getting pregnant, have a personal or family history of depression, experienced pregnancy or birth complications, or have a child who was hospitalized after birth. People who lack support from family and friends or experience a stressful life event, like a family illness or the recent loss of a loved one, are also at greater risk.

While PPD is different for everyone, signs of the condition are similar to those associated with major depressive disorder. If you have PPD, you are likely to experience a variety of symptoms, like:

  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often than usual
  • Feeling angry
  • Withdrawing from family and friends
  • Feeling disconnected from the baby
  • Worrying that you may hurt your baby
  • Feeling guilty about not being a good parent
  • Experiencing suicidal thoughts

Seeking help for PPD is essential
Symptoms of PPD usually occur one to three weeks after delivery, but they may arise up to a year after giving birth. If you think you may suffer from PPD or if you develop any of the warning signs associated with the condition, it’s important to talk to your HCP right away. Untreated PPD can make it harder to properly care for your child and, in more extreme cases, cause thoughts of suicide or of harming your baby. If you’re feeling like you want to hurt yourself or your baby, call 911 immediately.

Whether your HCP recommends Zulresso, other medications, talk therapy, or something else, there are many effective ways to treat your symptoms. Your HCP will work with you to determine what course of action is right for you.

Article sources open article sources

Office on Women’s Health. Postpartum Depression. Page last updated February 17, 2021. Accessed July 21, 2022. Statistics on Postpartum Depression. Page last updated on March 21, 2022. Accessed July 21, 2022.
American College of Obstetricians and Gynecologists. Postpartum Depression. Page last updated December 2021. Accessed July 21, 2022.
Centers for Disease Control and Prevention. Depression Among Women. Page last reviewed May 23, 2022. Accessed July 21, 2022.
Mayo Clinic. Postpartum Depression. Page last reviewed May 24, 2022. Accessed July 21, 2022.
Yusra Azhar and Amad U. Din. Brexanolone. StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
NIH: National Library of Medicine. Label: Zulresso—brexanolone injection, solution. June 20, 2022. Accessed July 21, 2022. Get the facts about Zulresso. 2022 Accessed July 21, 2022. Financial assistance programs from Sage Central. 2022. Accessed July 21, 2022.
NIH: National Institute of Mental Health. Perinatal Depression. 2022. Accessed July 21, 2022.

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