The First FDA-Approved Drug For Postpartum Depression Is Here — But There's A Catch

Photographed by Eylul Aslan.
The Food and Drug Administration (FDA) has approved the first drug to treat postpartum depression. According to the New York Times, on Tuesday, the FDA approved a drug called brexanolone to treat postpartum depression in adult women. The drug will be administered via injections into an IV and will be marketed under the name Zulresso.
According to the Times, brexanolone — a synthetic form of the hormone allopregnanolone, a derivative of progesterone — begins to work to treat moderate to severe postpartum depression within 48 hours. This is an improvement over antidepressants currently used to treat postpartum depression, which generally take two to four weeks to begin working, and sometimes show no effect at all. According to the CDC, in the US, about one in nine cisgender women who give birth experience postpartum depression, and the prevalence is higher — up to one in five — in certain states. (The CDC doesn’t provide information on the prevalence of postpartum depression in others who give birth.)
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"Postpartum depression is a serious condition that, when severe, can be life-threatening. Women may experience thoughts about harming themselves or harming their child. Postpartum depression can also interfere with the maternal-infant bond. This approval marks the first time a drug has been specifically approved to treat postpartum depression, providing an important new treatment option," Tiffany Farchione, M.D., acting director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research, said in a press release.
However, Zulresso comes with a high price tag. Because of potential side effects — including dizziness, sleepiness, and, more rarely, fainting — it will only be administered through a restricted program. In this program, the patient must remain under medical supervision in a certified medical center while they receive Zulresso via IV infusion. Manufacturer Sage Therapeutics told CNN that this treatment will cost between $20,000 and $35,000 per treatment — not including the cost of the stay in the medical center. The treatment will also take 60 hours (people can continue breastfeeding during this time). It will be available in June.
Sage Therapeutics told the New York Times that they expect insurance companies to cover the treatment, however, insurance companies told the Times that they are evaluating brexanolone. Sage Therapeutics is also working on developing a more-accessible pill that would treat both postpartum depression and major depression, and expects to submit it for FDA approval within a couple years if clinical trials continue to show results.
While Zulresso will only be available to those who can afford it, studies indicate that low-income parents are at a higher risk for postpartum depression. A 2010 study by the University of Rochester Medical Center found that 56% of low-income urban mothers met the criteria for postpartum depression, compared to a national average of 14%. The CDC lists "stressful life events," "low social support," and "being a teen mom" as risk factors for postpartum depression. And though "poverty" isn't included on that list, it sounds like it should be.
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