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Content Update

May 06, 2024

Zuranolone (Zurzuvae): The First Oral Agent Approved for the Treatment of Postpartum Depression: In August 2023, the U.S. Food and Drug Administration (FDA) approved zuranolone (Zurzuvae), a novel allopregnanolone analogue, for the treatment of postpartum depression. The efficacy and safety of a once-daily treatment were investigated in two, double-blind, multicenter phase 3, randomized clinical trials. The ROBIN and SKYLARK studies suggest that zuranolone may be an effective and timely treatment option for postpartum depression during the third trimester of pregnancy or in the first month following delivery, with symptom improvement witnessed as soon as 1 week after starting treatment. The studies concluded that zuranolone is well tolerated and not associated with an increased risk of suicidality. Additional research is needed to determine if zuranolone is effective in people with comorbid mental illnesses such as schizophrenia and safe in the setting of breastfeeding.

Content Update

April 18, 2023

Zuranolone (Zurzuvae): The First Oral Agent Approved for the Treatment of Postpartum Depression: In August 2023, the U.S. Food and Drug Administration (FDA) approved zuranolone (Zurzuvae), a novel allopregnanolone analogue, for the treatment of postpartum depression. The efficacy and safety of a once-daily treatment were investigated in two, double-blind, multicenter phase 3, randomized clinical trials. The ROBIN and SKYLARK studies suggest that zuranolone may be an effective and timely treatment option for postpartum depression during the third trimester of pregnancy or in the first month following delivery, with symptom improvement witnessed as soon as 1 week after starting treatment. The studies concluded that zuranolone is well tolerated and not associated with an increased risk of suicidality. Additional research is needed to determine if zuranolone is effective in people with comorbid mental illnesses such as schizophrenia and safe in the setting of breastfeeding.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Explain the etiology and pathophysiology of major depressive disorder (MDD).

  2. Identify the signs and symptoms of MDD.

  3. Outline the treatment goals for a patient with MDD.

  4. Recommend pharmacotherapy given a specific patient with MDD.

  5. Develop a monitoring plan for a specific patient with MDD that includes the assessment of efficacy as well as adverse effects.

  6. Predict, prevent, identify, and resolve potential drug-related problems.

  7. Educate patients and caregivers on the proper use of antidepressant therapy.

INTRODUCTION

Major depression is a common, seriously disabling disorder nonresponsive to volitional efforts to feel better. Individuals with major depressive disorder (MDD) experience pervasive symptoms affecting mood, thinking, physical health, work, and relationships. Inadequately treated MDD increases the risk of suicide.1

Although antidepressants and agents used adjunctively in depression account for 16 of the top 200 prescription drugs dispensed in the United States, inadequate treatment remains a serious concern.2,3...

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