A ground breaking treatment for postnatal depression is set to be made available in the United States, after the Food and Drug Administration (FDA) approved a fast-acting antidepressant pill to treat the condition.
The zuranolone pill, sold under the brand name Zurzuvae in the US, is the first of its kind approved for treating depression in women who have recently given birth. The medical milestone has the potential to target and treat the chemical imbalances that cause depression and anxiety within just two weeks.
While Australia treats post- and perinatal depression with antidepressant medication, our system has not approved any medications specifically for postnatal depression, nor do we offer this fast-acting solution.
Dr Nicole Highet, the Founder and Executive Director of Australia’s Centre of Perinatal Excellence (COPE) and the Chairperson of the 2023 Perinatal Mental Health Guidelines, welcomes the development of this treatment.
“If you think about what it’s like to live with anxiety and depression on a day-by-day basis, put on top of that the demand for caring for a new baby, sleep deprivation, etcetera. It exacerbates the condition when you can’t engage in self care because you’ve got the demands of an infant,” Dr Highet told marie claire Australia.
“Anything that’s going to act quickly and help restore a person’s mental health sooner is a really positive step forward.”
According Dr Highet, one of the key failings of current available treatments in Australia is the lengthy time period they take to be effective.
“One of the challenges of any antidepressant [treatment] is that it can take four to six weeks for the medication to start taking effect,” she explains. “And obviously if you’re struggling with anxiety or depression, plus the demands of a new baby or pregnancy, that can be extra demanding. So something that acts quickly has obviously got significant benefit.”
The new FDA-approved pill can reportedly start to show results within three days.
The latest national report cites 1 in 5 (20%) Australian mothers of children aged 24 months or less had been diagnosed with depression. More than half of these mothers reported being diagnosed with depression during the perinatal period.
Is It Safe To Take Antidepressants During Or After Pregnancy?
Dr Highet notes that treatments are prescribed on a case-by-case basis. However, when it comes to medications, or even the nature of postpartum depression itself, she notes there are many false apprehensions — both among GPs and in the general public.
In Australia, one of the most common treatments for depression during pregnancy and post-partum are selective serotonin reuptake inhibitors (SSRIs), which Dr Highet confirms are absolutely safe.
“We know there’s not enough education around [medication for postnatal depression]. We know GPs are often telling patients to come off their medication, when it’s actually more detrimental to come off your medication than to go onto it,” she tells marie claire Australia.
“There is a strong need for better education amongst prescribing health professionals. We hear time and again that women are going back to their psychiatrist and saying their GP told them to go off their medication, or they want to go off the medication themselves because they have this perception that putting medication in their bodies is bad for their developing baby or bad during breastfeed, when that’s simply not the case.”
Dr Highet adds that the stigma associated with taking antidepressant medication post-natally often discounts the serious nature of the condition, and also the long-term effects of postnatal depression on an individual, family and child.
“For people who have severe anxiety and depression that’s not treated, not only does it affect them and their relationships but also their ability to bond with an infant. That can have a lifelong trajectory. It affects that infant’s attachment, it impacts their growth and development, and there are studies that have shown children that have had poor attachment due to mothers with postnatal depression, for example, have been at higher risk of mental health and behavioural problems in childhood, mental health problems in adolescence and through to adulthood,” she explains. “Letting the debilitating impacts of these conditions continue over long periods of time… the cost-benefit analysis of early intervention is key because it’s not only the mother who is affected, but also others in the family, including the child or children.”
While the latest COPE guidelines — which are used to inform treatments for a range of mental health diagnoses, during and after pregnancy — acknowledge the use of zuranolone as an “emerging pharmacological intervention”, it suggests more evidence is needed. It does, however, strongly recommend antidepressant medication be used when needed.
If you are struggling during or after your pregnancy, talk to your GP. For 24/7 crisis support, call Lifeline