Zuranolone shows sustained PPD symptom improvement through day 90

An ongoing, prospective, observational study of zuranolone (Zurzuvae; Biogen and Supernus Pharmaceuticals) for postpartum depression (PPD) found that patient-reported depressive symptoms continued to improve through day 90, with remission rates rising throughout follow-up. The findings for zuranolone, the first and only 14-day oral treatment approved in the United States for PPD in adults, were presented in a poster at Psych Congress 2026 in New Orleans, Louisiana.¹

Participants were adults aged 18 years and older who filled zuranolone prescriptions for PPD through a national specialty pharmacy between December 22, 2025, and June 22, 2026.¹ Depressive symptoms were assessed using Edinburgh Postnatal Depression Scale (EPDS) total scores at days 0, 15, 45, and 90. At day 45, participants were asked about breastfeeding behavior, and at days 45 and 90, they were asked whether they had initiated a new PPD treatment.¹

Sustained PPD symptom improvement

• Analysis included 99 participants who completed surveys at all time points, against a target enrollment of 200
• Mean (SD) baseline EPDS score was 18.8 (4.5)
• Mean EPDS score decreased from baseline by 9.9 points (95% CI, 8.7-11.1) at day 15, 10.8 points (95% CI, 9.6-11.9) at day 45, and 12.2 points (95% CI, 11.0-13.4) at day 90
• By baseline severity, mean EPDS reductions at day 90 were 6.0 points for mild PPD, 10.57 points for moderate PPD, and 15.77 points for severe PPD, (P < 0.001)
• Remission (EPDS score <10) was achieved by 57.6% (95% CI, 47.2-67.5) of participants at day 15, 67.7% (95% CI, 57.5-76.7) at day 45, and 72.7% (95% CI, 62.9-81.2) at day 90
• Most participants (60.6%) received zuranolone as monotherapy, and it was initiated as first-line PPD therapy in 53.5% of participants
• At day 45, 79.6% of participants reported no new PPD treatment after zuranolone; at day 90, 88.7% reported no new treatment in the prior 30 days
• More than half of participants (53.1%) reported continuing to breastfeed during zuranolone treatment, and among those, 84.6% fed as usual
• Among participants who did not breastfeed during treatment, 67.7% never breastfed or discontinued breastfeeding for reasons unrelated to zuranolone

Symptom improvement was consistent across baseline severity groups

Reductions in EPDS scores were observed across all baseline severity subgroups, with participants who started treatment with severe PPD showing the largest absolute point reductions by day 90. The authors described the improvements as statistically significant and clinically meaningful through the full 90-day follow-up period.¹

“These real-world findings support the sustained effects of zuranolone in PPD and provide additional evidence regarding treatment patterns after therapy and breastfeeding practices during treatment,” wrote the poster authors. “treatment. The final results of this study will provide additional insights into real-world zuranolone outcomes.”

Findings align with earlier, separate real-world data on zuranolone's onset

A related but distinct real-world study, an interim analysis of 191 participants presented at the Postpartum Support International Conference in June 2026, similarly found more than half of participants reaching remission by day 15 (55%), rising to 67% by day 45, with mean EPDS score reductions of 8.91 points at day 15 and 10.24 points at day 45.²

"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 3 to 5," said Joy Baker, MD, FACOG, PMH-C, C-EFM, MT(ASCP), an OB-GYN with Wellstar West Georgia Medical Center and a coauthor of that separate study, in a previous interview with Contemporary OB/GYN.

References:

1. James J, Bian B, Ortega-Villa AM, et al. Long-term patient-reported outcomes with zuranolone for postpartum depression: a real-world observational study. Poster No. 176 presented at: Psych Congress 2026; September 17-18, 2026; New Orleans, LA.
2. Fitch J. Joy Baker, MD, talks zuranolone's onset for postpartum depression. Contemporary OB/GYN. Published July 30, 2026. Accessed September 2026.