A woman's arm is shown attached to an IV as she lies in a hospital bed.
A more challenging aspect of a new treatment for postpartum depression is that it must be administered intravenously over a 60-hour period. (For Spectrum Health Beat)

One of the handy things about social media is it gives you a chance to see what others are saying about a given topic.

You can be an armchair psychologist. Or a curious sociologist.

You get to measure public sentiment on just about anything.

Want to know what neighbors and others in the community think about the new restaurant down the street? Check out the ratings and comments on Yelp.

Wonder about the latest hot take on a politician’s speech? Run a hashtag search on Twitter. It’ll give you a quick bead on both sides of the aisle.

I’m in the health care field, so I tend to be drawn into posts about health topics.

Particularly pregnancy and childbirth.

One topic I’ve noticed stirring up controversy on social media recently is Zulresso, a new medication for postpartum depression.

If you keep up on science and health care news, you might remember the FDA only recently approved this drug—and it’s the first time the agency has approved a drug specifically for postpartum depression.

In past stories, I’ve written about postpartum depression and how it differs from other conditions.

The FDA has recognized postpartum depression as a serious and potentially life-threatening condition.

“Women may experience thoughts about harming themselves or harming their child,” Tiffany Farchione, MD, acting director of the division of psychiatry products in the FDA’s Center for Drug Evaluation and Research, stated in a release. “Postpartum depression can also interfere with the maternal-infant bond.”

But this new medication carries some serious risks, including excessive sedation and sudden loss of consciousness during administration.

Consequently, the FDA has placed added restrictions on it.

Risk strategy

The FDA approved Zulresso with what the agency calls a risk evaluation and mitigation strategy—more stringent conditions under which the medication is approved and administered.

The conditions:

  • The medication is only available to patients through a restricted distribution program at certified health care facilities where a health care provider can monitor the patient.
  • The drug is administered intravenously to the patient over a continuous period of 2 1/2 days, which means the patient must stay at a certified facility while receiving the drug. This in itself is quite a limiting condition.
  • The patient must be monitored by health professionals while taking this medication. During the 2 1/2-day period when the drug is administered, a mother cannot have unaccompanied interactions with her children—she needs to be monitored by someone.
  • The medication can have a sedative effect that lasts beyond the 2 1/2-day period in which the drug is administered. So the patient cannot drive a vehicle or engage in other activities until the sleepiness passes.

It’s also worth noting that the medication can cross into breastmilk, which means breastfeeding needs to be put on hold for a bit if you’re taking this medication.

The medication is expected to cost more than $34,000.


There’s little doubt this new drug will find a place in health care.

According to the American Psychological Association, about 1 in 7 women experience postpartum depression.

This isn’t to be confused with baby blues. About 60% to 80% of women experience baby blues, which includes feelings of sadness, anxiety, weepiness, feeling overwhelmed or trapped and having trouble sleeping.

Baby blues typically starts fairly soon after delivery and goes away on its own a few weeks later. We think baby blues arises from the physical and emotional changes after having a baby.

And of course, there are plenty of changes.

According to the National Institutes of Health, postpartum depression can be characterized by feelings of extreme sadness or anxiety, which can interfere with the mom’s ability to care for herself or her family.

While these feelings can begin before or after childbirth, they typically begin a week to a month after the delivery of the baby.

The severity of the symptoms can mandate treatment.

In clinical trials, the drug manufacturer solicited participation from about 250 women who suffered either severe or moderate postpartum depression. One group received a placebo, the other received brexanolone.

According to the manufacturer, Zulresso reduced depression symptoms within 24 hours of beginning the medication. (This can differ from many antidepressants, which often take longer to work.) The manufacturer also noted the medication maintained its effects beyond a 30-day follow-up period.

Adverse reactions to the drug included sleepiness, feeling flush and experiencing dry mouth.

The drug won’t be a treatment solution for all women, especially given the stringent conditions under which it’s administered.

But under the right circumstances, it might prove to be an important new treatment for postpartum depression.