Zulresso IV Infusion for Treatment of Postpartum Depression

Postpartum depression refers to depressive symptoms that occur after giving birth. For weeks and months after giving birth, women with this condition may feel anxious, sad, worthless, guilty, and even suicidal. They might have little interest in activities they used to enjoy doing in the past, find it difficult to think or concentrate, and may experience significant changes in their sleep or appetite. 

In the past, treatments for postpartum depression have been similar to the treatments offered to non-pregnant patients struggling with depression. For instance, many women with postpartum depression have been prescribed antidepressant medications, like selective serotonin reuptake inhibitors (SSRIs). However, in 2019, the US Food and Drug Administration (FDA) approved brexanolone (brand name Zulresso), the first drug targeted at the treatment of postpartum depression. In this article, we will try to explain how effective is Zulresso Infusions for Postpartum Depression.

What is Zulresso and how does it work?

Brexanolone (Zulresso) is a steroid gamma-aminobutyric acid (GABA) receptor modulator. GABA is a neurotransmitter, meaning it transmits messages between nerve cells by binding to receptors on postsynaptic nerve cells. GABA is an inhibitory neurotransmitter—it is the principal inhibitory neurotransmitter in the nervous system. As a GABA receptor modulator, Zulresso changes the GABA receptors’ response. And through its impact on the GABA system, Zulresso produces a relaxing and calming effect.

It is also worth noting Zulresso is identical, in its chemistry, to the naturally occurring steroid, allopregnanolone. This steroid is a metabolite of progesterone, a hormone that plays an important role in pregnancy. The levels of allopregnanolone rise during pregnancy but drop soon after giving birth. Perhaps the drop in allopregnanolone levels explains the occurrence of postpartum depression. But scientists do not know for sure. Presently, the most commonly suggested mechanisms of postpartum depression include GABA signaling, changes to the hypothalamic-pituitary-adrenal axis (involved in the body’s response to stress), and hormonal fluctuations (like changes in allopregnanolone levels).

Zulresso side effects

Zulresso infusion is a new and effective treatment for postpartum depression. However, it involves potentially serious risks (severe sedation or loss of consciousness). Other common side effects of Zulresso include sleepiness, headache, dizziness, vertigo, dry mouth, and flushing. These side effects need to be balanced against the considerable benefits of this treatment: The FDA’s approval of this drug was based on two trials in which depression scores were significantly lower in the treatment group (compared to the placebo group). In the trial involving severe postpartum depression, the scores remained lower than the placebo group, even a month after the treatment.

Zulresso infusion treatment centers

Due to risks and potential side effects of this drug, patients need to enroll in the Risk Evaluation and Mitigation Strategy (REMS) program before they are permitted to receive this treatment. This is done to make sure the provider has the skills and resources needed to monitor their patients during the treatment. So, Zulresso can only be administered by a health professional working in a certified healthcare setting.