@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
Mara Rivera, MD | Repro Psych
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Thursday 30 July 2026 15:19:16 GMT
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dap1069
Apple User794467 :
Then why in the heavens was this Not offered to Lindsey First!
2026-08-11 11:53:26
27
jmartinez4068
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
0
drcyrusmontes
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
12
rachelshuster
Rachel Shuster :
It SAVED my life. I felt like I had ME back by day 3
2026-08-09 00:39:45
45
tayyyyyhere
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
75
kutie1011
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
15
byebyebye777
byebyebye777 :
Better alternative is just bioidentical progesterone
2026-08-09 05:23:39
8
dapplegraymanor
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
17
sydneynist
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
6
saramichross
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.roxanne
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
23
user9183741819103
User1928572010 :
It’s $16,000! 😫
2026-08-07 01:59:44
10
kelleylynne24
Kelley :
No one wants to cover it. The PA for this is ridiculous
2026-08-13 01:31:08
5
birthday.bird8
Birthday Bird :
Prophylaxis use?
2026-08-09 17:48:41
0
nurse_yogi
Nurse_yogi :
Can you breastfeed while on this medication?
2026-08-11 18:20:08
1
nicolemariecampan
Nicole Marie Campane :
Was this originally only offered as IV inpatient? Or is that a different medicine?
2026-08-07 23:44:02
12
laurelpants
Lauren Thomas :
Why not just try micronized progesterone?
2026-08-12 00:18:07
3
bonitabere
Berenice Sanchez :
It’s a 2 week trial, & people see results as early as 3 days*
2026-09-09 18:16:29
2
mentalhealthallison
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
6
alexandriataylor001
Alexandria Taylor :
I’ve taken this! Legit MIRACULOUS
2026-08-14 11:29:10
2
mayraivonmoreno
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
1
itsnurseamy
itsnurseamy :
This is the same mechanism for PMDD, correct? I’ve been reading studies on it!
2026-08-21 02:38:08
2
lifetimeoffinn
Finn’s Journey 🩵 :
Is it safe for breastfeeding?
2026-07-30 21:42:00
1
drmararivera
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
2
jmartinez4068
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
0
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