Why the new postpartum depression drug could destigmatize PPD entirely

When I heard that the FDA had approved the first-ever drug to treat postpartum depression, I was thrilled. Given how commonplace this serious mental health condition is, and how severe the impact can be on the entire family, I’ve always wished for a greater arsenal to help fight it and treat it.

That’s where Zulresso comes in. It’s the first drug formulated exclusively to treat postpartum depression, it’s demonstrated relatively minimal side effects in trials, it is similar to progesterone in structure, and it’s expected to hit the market in June.

Of course it won’t be cheap. According to CNN, Zulresso will cost $20,000 to $35,000 per treatment. Hopefully covered by most insurance. (MASSIVE HINT TO INSURANCE COMPANIES.) Plus, the drug is administered through a continuous 60-hour IV drip, so this is not as simple as say, taking a pill once a day.

That said, the results of the study look really promising, especially for mothers with the most severe cases of PPD. Considering that the Zulresso works within hours (wow) for most patients, suffering moms don’t have to wait weeks to start feeling better.

That could literally be the difference between life and…well, some not-so-good stuff, for those with the most severe cases.

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I don’t like this picture very much. Not because of the caverns of sleep deprivation under my eyes…but because it brings me right back to a time when I was skating on the edge of okay with a postpartum mood disorder. ? Fast forward 10 years and I’m definitely posting it, because yesterday ??the FDA approved the first-ever drug specifically for postpartum depression. My husband, as you guys may know, is a psychiatrist who runs the inpatient psychiatric unit of a major academic hospital in NYC…where they will be using the treatment. Hello, work worlds colliding! ??? We’re on vacation at the moment, so I decided to interview him as we got our boys ready for ski school this morning: ??? Me: You’re excited about this drug. Dr. B.: Yes, for sure. It’s an antidepressant that has a novel mechanism. It’s structurally very similar to progesterone. Me: Hang on. You went straight to the chemistry. Progesterone is a naturally occurring hormone during pregnancy, right? So when you give birth, you have less of it? Dr. B.: Yes, that’s right. This drug is an important option for women who don’t respond to standard treatments like antidepressants or psychotherapy. It requires a 60-hour infusion in a hospital setting and rapidly reduces symptoms. Me: But if it works really well, and quickly, why wouldn’t you go straight to that? Dr. B.: I would anticipate that most women will probably want to stay in their own homes with their babies. But I do think this drug can be a first-line option for women who prefer this treatment. Me: Do you think insurance companies will see it that way? Dr. B.: Great question. I would be cautiously optimistic that they will cover it for women who are truly in need, which is a significant population. Me: The first thing that occurred to me when I read this news was that the treatment could help destigmatize postpartum depression. If there’s a medicine to treat it that works so quickly, no one can say it isn’t real. Dr. B.: I hope you’re right. Depression is a medical illness. It is one of the leading causes of disability worldwide. Me: Disability comes up in my Fifth Trimester work when moms have taken ⬇️<continued in comments>

A post shared by The Fifth Trimester (@thefifthtrimester) on Mar 20, 2019 at 2:32pm PDT

We all especially loved reading this Instagram post from our friend Lauren Smith Brody, author of The 5th Trimester, who interviewed her psychiatrist husband about Zulresso and shared his encouraging perspective.

But above all, she makes an extremely important observation that having a medicine on the market that treats the symptoms of PPD so quickly, it could entirely destigmatize postpartum depression, by “proving” that it’s a real condition.

(Note to naysayers: It’s a real condition.)

Above all, I’m just so encouraged to know that researchers are devoting time and money to finding solutions for postpartum mood disorders for new moms, since they’re still written off “baby blues” or an “adjustment period” that will remedy itself.

Of course, I’m also hopeful that more drugs will be forthcoming, hopefully in a form that doesn’t require patients to be attached to an IV for 60 hours. But as most moms who survived serious PPD will tell you, 2.5 days in a hospital is a pretty small price to pay for instant results that get them back to feeling themselves, and the ability to continue building a healthy relationship with their newborns.

Top image: Kevin Liang via Unsplash