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News|Videos|July 10, 2026

Highlighting zuranolone's real-world effectiveness on postpartum depression with Joy Baker, MD

Key Takeaways

  • Real-world data show clinically meaningful EPDS improvement across mild, moderate, and severe postpartum depression, supporting broader clinician use of zuranolone.
  • Oversampling of moderate PPD patients helps close an evidence gap left by pivotal trials that enrolled predominantly severe cases.
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The phase 4 study's oversampling of moderate PPD patients, showing a nearly 9-point EPDS drop by Day 15, helps close a gap left by trials that enrolled predominantly severe cases.

A phase 4, prospective, real-world study of zuranolone (Zurzuvae; Sage Therapeutics and Biogen) for postpartum depression (PPD) produced clinically meaningful symptom improvement across all baseline severities, findings that co-author Joy Baker, MD, OBGYN, FACOG, PMH-C, C-EFM, MT(ASCP), said should increase clinician comfort in prescribing the oral treatment beyond severe disease.1,2

The study followed 191 participants who completed all 3 Edinburgh Postnatal Depression Scale (EPDS) assessments at Day 0, Day 15, and Day 45, a 94.6% retention rate among 202 enrolled. Across the full cohort, mean EPDS scores fell by 8.91 points at Day 15 and 10.24 points at Day 45 (both P < 0.001), with more than half of participants reaching the remission threshold (EPDS < 10) by Day 15 (55%), rising to 67% by Day 45.

Baker, of Wellstar West Georgia Medical Center, LaGrange, GA, and co-author of the real-world effectiveness study, summarized the findings.

“What we found was consistent clinically meaningful improvement in the Edinburgh Postnatal Depression Scale, or the EPDS scores, across all 3 severity ranges for patients,” she said in the above interview with Contemporary OB/GYN. “By the end of that 14-day treatment course, that improvement was recognized in their scores and their reported symptoms, and that improvement was sustained up to a month later.”

Closing the moderate PPD gap

Because pivotal trials enrolled predominantly patients with severe PPD, Baker highlighted the study's intentional oversampling of the moderate group (EPDS 14 to 19), which made up 53.4% of the analyzed cohort.

“Most of the people tend to live in that moderate range,” Baker said. “Seeing a statistically significant difference in that EPDS score, nearly a 9-point drop by day 15, definitely sealed the deal in my mind that for that subgroup, that zuranolone is an appropriate medication to have in your toolkit.” Specifically, moderate PPD participants saw mean reductions of 8.59 points at Day 15 and 9.62 points at Day 45.

Speed of onset as a counseling point

Baker emphasized the treatment's rapid trajectory as clinically distinct from traditional antidepressants.

“This is a 14-day oral treatment with fast trajectory, so you do not need to wait weeks or months to feel a difference. Most patients report a change in symptoms, or a decrease in symptoms, by days 3 to 5,” she said, contrasting this with the 2-to-6-week onset she describes for other antidepressant therapies.

“Real-world prescribers are increasingly getting comfortable using zuranolone as a starting point rather than a last resort,” Baker said. Zuranolone served as first-line therapy for 51.8% of participants, while 71% of patients did not report starting a new type or class of PPD treatment at day 45.

Editor’s note: Joy Baker has relevant disclosures for Biogen and Supernus.

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 meeting. June 24-28, 2026. Los Angeles, California.
  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 10, 2026. https://www.contemporaryobgyn.net/view/zuranolone-postpartum-depression-real-world-interim-day-45

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