@drmararivera: Zuranolone, brand name Zurzuvae, was approved by the FDA in 2023. It is the first oral medication approved specifically for postpartum depression. It is not an antidepressant. It is a neuroactive steroid that acts on GABA rather than serotonin. During pregnancy, allopregnanolone rises steeply and then drops sharply after delivery. Zuranolone is thought to work by addressing that drop. In the SKYLARK trial, women with severe postpartum depression took zuranolone nightly for 14 days. Symptoms improved by day 3 compared with placebo, and the effect held through day 45. The course is 14 days, not ongoing. There are some real risks to consider. It causes sedation and patients cannot drive for 12 hours after a dose. It was studied only in severe postpartum depression and followed only to day 45. Cost and access remain significant barriers to its use. Sources: Deligiannidis et al., American Journal of Psychiatry, 2023. Educational only, not medical advice. #postpartumdepression #zuranolone #zurzuvae #ppd #newmom
Mara Rivera, MD | Repro Psych
Region: US
Thursday 30 July 2026 15:19:16 GMT
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Apple User794467 :
Then why in the heavens was this Not offered to Lindsey First!
2026-08-11 11:53:26
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Jes85 :
it makes you super sleepy at night but how do you function in the daytime???
Anybody who has taken it can answer!!
2026-08-20 19:38:36
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Dr. Cyrus|Psychiatrist DO, MHA :
so many of the moms I think will be good candidates for this have no night time support. :(
most also have no daytime support
2026-08-10 02:27:33
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Rachel Shuster :
It SAVED my life. I felt like I had ME back by day 3
2026-08-09 00:39:45
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tayyyyyhere :
i remember by day 7 i noticed the sun was shining and my brain felt calm again and i stopped crying every 2 seconds, it saved me and let me actually enjoy the rest of my maternity leave with my baby and im so grateful my insurance covered it
2026-08-11 03:13:03
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TicToc :
I honestly believe putting women on hormone replacement may help with depression PPMD etc... like progesterone has helped so many women.... estrogen and testosterone as well.
2026-08-13 01:29:39
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byebyebye777 :
Better alternative is just bioidentical progesterone
2026-08-09 05:23:39
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DapplegrayManor :
Wait. So I’ve had generalized anxiety my whole life. I take a small dose of Celexa and have been for 30 years (I’m 52). But once I started taking progesterone and estrogen for perimenopause, my anxiety disappeared 😳. For two years I’ve just been raw dogging life- no lists, no rumination, nothing. It’s relaxing but it’s…just so weird. Is it possible that the progesterone is raising my allopregnanolone /GABA?
2026-08-10 22:44:16
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Syd :
This med made me su!c!dal I had to stop on day 5. I’m still traumatized. I’m so happy it works for most mommy’s though.
2026-07-31 04:49:15
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Sara Ross :
my insurance covered it the first time, if for some reason they didn’t cover it again, I would pay every single penny for it. over and over.
2026-08-08 05:04:25
22
Alyssa :
My psych NP ranted to me about how hard she fights insurance companies to get it covered for her patients because it is so expensive. Insurance companies suck!
2026-08-09 08:29:52
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User1928572010 :
It’s $16,000! 😫
2026-08-07 01:59:44
10
Kelley :
No one wants to cover it. The PA for this is ridiculous
2026-08-13 01:31:08
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Birthday Bird :
Prophylaxis use?
2026-08-09 17:48:41
0
Nurse_yogi :
Can you breastfeed while on this medication?
2026-08-11 18:20:08
1
Nicole Marie Campane :
Was this originally only offered as IV inpatient? Or is that a different medicine?
2026-08-07 23:44:02
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Lauren Thomas :
Why not just try micronized progesterone?
2026-08-12 00:18:07
3
Berenice Sanchez :
It’s a 2 week trial, & people see results as early as 3 days*
2026-09-09 18:16:29
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Allison May - Psych NP :
Ugh it's so cool. Big fan. Wish more people talked about it. Thank you for this content.
2026-08-01 20:05:16
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Alexandria Taylor :
I’ve taken this! Legit MIRACULOUS
2026-08-14 11:29:10
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Mayra Ivon :
Is this similar to the "mirena crash" ? withdrawal from progesterone from the IUD. I had mine removed at 5 years and the ob/gyn refused to replace it despite having no ongoing issues. she stated its just not normal for you to not have periods 🙄I immediately started having psychological symptoms aside from other withdrawal symptoms. By month 4 I started having SI thoughts. I had already seen a couple therapist and 1 psychiatric NP. The NP on the first appointment gave me a questionnaire with like 10 questions spoke to me 10 minutes via telemedicine and she diagnosed me with mania bipolar and depression. My only previous psychiatric dx had been Adhd and had been dx like 4 yrs prior to that. At that appt the NP Rx like 3 or 4 medications and told me she would not be managing my adhd because she didnt belive in that. 😳 I knew this could not be right. I asked if she was going to order any test and was offended. 😳 Turns out I had progesterone withdrawals my thyroid was off and getting my iud replaced fixed me right up. 😳 😏
2026-08-12 04:38:26
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itsnurseamy :
This is the same mechanism for PMDD, correct? I’ve been reading studies on it!
2026-08-21 02:38:08
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Finn’s Journey 🩵 :
Is it safe for breastfeeding?
2026-07-30 21:42:00
1
Mara Rivera, MD | Repro Psych :
Breastfeeding info: When considering medication in breastfeeding we look at the relevant infant dose (RID). Ideally we want it less than 1%, which is the case for zurzuvae. In repro psych we take a risk vs risk approach. There is no long term studies on breastfed infant however, it can be life changing for some women and fortunately is a less than 1% RID.
2026-08-13 13:23:32
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Jes85 :
Somebody please help me with patient assistance!!! My DIL needs this desperately! It's looking like ins may not cover it, how do we get PA!!? We are in tx!
2026-08-24 21:31:45
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