Joy Baker, MD, talks zuranolone's onset for postpartum depression

The rapid onset of zuranolone (Zurzuvae; Sage Therapeutics and Biogen) gives clinicians a meaningfully different counseling conversation for postpartum depression (PPD) than traditional antidepressants, according to Joy Baker, MD, FACOG, PMH-C, C-EFM, MT(ASCP), an OB-GYN with Wellstar West Georgia Medical Center in LaGrange, Georgia, and coauthor of a phase 4, prospective, real-world study of the oral treatment.

In that study, 191 participants completed all 3 Edinburgh Postnatal Depression Scale assessments, with more than half reaching remission by day 15 (55%), rising to 67% by day 45.^1,2

Across the full cohort, mean EPDS scores fell by 8.91 points at day 15 and 10.24 points at day 45 (both P < .001). Improvements were observed across every severity group. Participants with moderate PPD saw mean reductions of 8.59 points at day 15 and 9.62 points at day 45, while those with severe PPD saw reductions of 10.89 and 12.04 points, respectively. Mild PPD reductions reached 3.42 points at day 15 (P = .026) and 6.95 points at day 45.

Baker emphasized that speed of relief is central to how she frames treatment for new mothers.

“This is a 14-day oral treatment with fast trajectory, so you don't need to wait weeks or months to feel a difference. Most patients report a change in symptoms or a decrease in symptoms by days three to five,” she said, adding that patients often tell her, “I'm not 100 yet, but I can see the light at the end of the tunnel.”

She contrasted this trajectory with other antidepressant therapies.

“I tell patients you may feel better before you even finish the 2 weeks, and that benefit tends to build rather than fade over the following weeks. So I think that's a meaningfully different conversation than when I'm talking about other antidepressant therapies, and I'm telling the patient maybe anywhere from 2 to 6 weeks before you feel a difference,” Baker said.

“Regardless of baseline PPD severity, participants treated with zuranolone experienced clinically meaningful symptom improvement by end of treatment (day 15) that was maintained through day 45,” the authors of the study wrote.

References:

1. Baker LJ, Nagle-Yang S, Bian B, et al. Real-world effectiveness of zuranolone in postpartum depression: interim results of a prospective observational study. Poster presented at: Postpartum Support International Conference; June 24-28, 2026; Los Angeles, CA.
2. Fitch J. Interim study finds sustained postpartum depression improvement through day 45 with oral zuranolone. Contemporary OB/GYN. Published July 2, 2026. Accessed July 30, 2026. https://www.contemporaryobgyn.net/view/zuranolone-postpartum-depression-real-world-interim-day-45