For the first time, mothers experiencing postpartum depression can take a pill approved specifically to treat their condition.
On Friday, Aug. 4, the U.S. Food and Drug Administration (FDA) approved Zurzuvae, the first oral medication for the treatment of postpartum depression in adults.
Postpartum depression is a medical condition estimated to affect 1 in 8 women, most commonly occurring within six weeks after childbirth. It is characterized by intense feelings of sadness, anxiety, and tiredness that make it difficult for mothers to take care of themselves and their infants. Genetics, hormones, a history of psychological conditions such as depression or anxiety, and social life stressors such as a lack of social support or experiences of domestic violence are all factors associated with the development of postpartum depression.
The first drug for the treatment of postpartum depression was approved by the FDA in 2019, an intravenous treatment known as Zulresso. However, there are notable barriers to accessing the treatment due to its form of administration — which requires staying at a healthcare facility — along with its high cost.
Unlike general antidepressants often used in the treatment of postpartum depression, which can take weeks to months to improve symptoms, data from clinical trials show that taking Zurzuvae can result in a significant reduction in depressive symptoms as early as three days into treatment. Zurzuvae is also taken for only 14 days, a much shorter duration than other medications for the treatment of depression.
According to the American College of Obstetricians and Gynecologists, screening for perinatal depression (a broader term referring to depression in the period from conception to post-pregnancy) and anxiety should occur at the initial prenatal visit, later in pregnancy, and at postpartum visits. However, a recent CDC survey found that 1 in 8 women reported that they were not asked about feeling depressed during their postpartum care.
ACHI noted the importance of depression screening for new mothers in our recently published infographic, “9 Points on a Healthy Birthing Journey.”
In 2020, nearly a quarter (23%) of new moms in Arkansas experienced depressive symptoms following a recent birth. Recent policy initiatives in the state have sought to increase awareness and screening of postpartum depression in Arkansas. For example, Act 316 of 2023 requires providers to facilitate screening of new mothers for depression within six weeks after the mothers give birth and requires insurers to cover the cost of the screenings. Although the FDA has approved the use of Zurzuvae for postpartum depression, insurance coverage of the medication and its cost to patients are unknown at this time.
Left untreated, postpartum depression can lead to chronic depressive disorder and suicide, a leading cause of maternal deaths in the U.S. Postpartum depression can also be a precipitating factor for depression among other family members, and children of mothers with untreated postpartum depression can develop behavioral and emotional problems. Notably, women of color are more likely to suffer from postpartum depression but less likely to receive treatment for their condition than white women. Ensuring equitable access to postpartum depression screening and treatment must be prioritized for these populations.
Data from the Centers for Disease Control and Prevention identify Arkansas as having the highest maternal mortality rate across all states reporting data, with 43.5 maternal deaths per 100,000 live births between 2018 and 2021. However, for all pregnancy-associated deaths between 2018 and 2019, Black non-Hispanic mothers were twice as likely to die compared to white non-Hispanic mothers in Arkansas, according to a legislative report by the Arkansas Maternal Mortality Review Committee. This calls for a comprehensive and inclusive effort not only to address postpartum depression but also to dismantle systemic inequities that contribute to disparate health outcomes.