Europe authorizes the first pill to treat postpartum depression

BarcelonaOne in ten mothers will experience persistent sadness, lack of energy, and difficulty bonding with their baby in the first year after birth. These conditions can eventually lead to a mental health disorder such as postpartum depression. Although it can be treated with psychological and psychiatric therapy, as well as hospitalization in severe cases, there are no specific pharmacological therapies in Europe, and the available options—antidepressants and serotonin reuptake inhibitors—are too generic and take too long to work. However, in the United States, for two years now, you can access the Zurzuvae, a pill that is estimated to halve the symptoms associated with the disorder. This Wednesday, the European Commission authorized its marketing.

On July 24, the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMA) already adopted a positive opinion for Zurzuvae and recommended granting an authorization to the Dutch subsidiary of the biotechnology company Biogen for this treatment specifically designed for. The drug, which is available in 20 mg, 25 mg, and 30 mg hard capsules, contains the active ingredient zuranolone, a steroid that enhances the activity of the neurotransmitter gamma-aminobutyric acid (GABA) and has been shown to exert antidepressant effects three days after starting treatment. These pills must be taken once a day for two weeks.

"We knew it would arrive soon, and it's very good news," says Dr. Alba Roca, a psychiatrist at the specialized perinatal mental health unit at Hospital Clínic, the only one in Catalonia and a pioneer in southern Europe, in a statement to ARA. Along with an individualized psychological plan, the expert emphasizes that the availability of a drug like Zurzuvae will speed up patients' recovery. Until now, the treatment was brexanolone, administered via intravenous injection requiring hospitalization and only within the framework of clinical trials.

"It won't be a solution for everything or for everyone, but in the indicated cases, yes. In fifteen days, it has the capacity to significantly improve many of the symptoms, including suicidal ideation and insomnia," she affirms. In this regard, she emphasizes that currently, on average, a woman treated in the unit can take a year from diagnosis to recovery. "With very severe depression, it's very difficult for a woman to follow guidelines or assimilate psychotherapy information. She needs to reduce symptoms, and that's where medication can come in," she concludes.

Increasingly complex cases

But what causes postpartum depression? The exact causes are unknown, but during the postpartum period, there is a sharp drop in progesterone levels, the hormone that prepares the uterus for pregnancy. Furthermore, it has been established that genetic and hormonal factors are at play, as well as psychosocial factors. A complicated pregnancy, a traumatic birth, loneliness while parenting, the loss of a child, or having previously suffered from a mental illness can all contribute to its onset, although any woman can develop it, regardless of these factors. In fact, it is one of the most common maternal illnesses yet underdiagnosed.

The period of greatest risk for suffering from postpartum depression is during the first weeks and up to the first three months after giving birth. However, 25% of women begin experiencing depression in the third trimester of pregnancy, and 20% develop symptoms after the sixth week of delivery. Roca points out that postpartum depression not only causes anxiety and guilt in women—who often describe experiencing sudden crying spells and insomnia, feeling irritable, or, in severe cases, having had thoughts of self-harm or suicide—but also impacts children's development and further impacts relationships.

"Untreated postpartum depression has a very high cost, both personal and social, especially for the baby, who will not be stimulated in the same way and needs its mother, with whom it has been bonded for nine months," says Roca, who admits that not only has demand for the unit increased, but also the number of cases reaching them.