Zuranolone

Zuranolone treats postpartum depression in adults. It is a 14-day treatment course that may be used alone or with an oral antidepressant. Depression after childbirth is a medical condition that deserves treatment and practical support.

Zuranolone enhances signaling at GABA-A receptors. GABA helps regulate the activity of brain cells. Its effects on this system can improve depressive symptoms and can also cause sleepiness and impaired coordination.

Some people notice improvement within days. Review mood and functioning during the course and after it ends. Benefit and the need for ongoing treatment vary.

Plan transportation and help with infant care before starting. You may not accurately recognize how much the medicine is affecting your alertness.

• Take your prescribed dose once each evening for 14 days, with food containing fat. Follow the meal guidance supplied with the medicine.
• Swallow capsules whole. Do not open, crush, or chew them.
• If you miss a dose, skip it and take the next dose at the usual time the following evening. Do not take an extra dose.
• Do not drive or do hazardous work for at least 12 hours after every dose. Avoid those activities longer if you remain impaired.

• Sleepiness or drowsiness
• Dizziness, slowed thinking, or poor coordination
• Fatigue or weakness
• Diarrhea

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Report excessive sedation, confusion, or trouble walking promptly; your provider may reduce the dose or stop treatment. Falls and breathing problems are more likely with other sedatives.

Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.

For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.

Discuss kidney or liver disease, falls, substance use, bipolar disorder, and every sedating medication you take.

Zuranolone may harm a developing pregnancy. Use effective contraception during treatment and for one week after the last dose if you could become pregnant.

Discuss breastfeeding with your provider before starting. The medicine enters breast milk; your plan should consider the available evidence, your symptoms, and your infant’s needs.

Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.

Avoid alcohol. Opioids, benzodiazepines, sleeping pills, and other sedatives can worsen impairment and may cause breathing problems.

Strong CYP3A4 inhibitors require a lower dose. CYP3A4 inducers can make treatment less effective and should be avoided. Have antibiotics, antifungals, antivirals, seizure medicines, and supplements checked.

Arrange help with nighttime feeding, carrying the baby, and other tasks if you are drowsy or unsteady.

Keep the follow-up visit after the 14-day course, even if you feel much better.

Store securely at room temperature, away from children. Zuranolone can be misused and may cause dependence. Do not share capsules; ask the dispensing pharmacy about disposal of leftovers.