US health officials approve first pill to treat postpartum depression

Federal health officials have approved the first pill specifically intended to treat severe depression after childbirth, a condition believed to affect around half a million women in the country every year.

The Food and Drug Administration on Friday granted approval for the drug, Zurzuvae, for adults experiencing severe depression related to childbirth or pregnancy. The pill is taken once a day for 14 days.

“Having access to an oral medication will be a beneficial option for many of these women coping with extreme, and sometimes life-threatening, feelings," said Dr. Tiffany Farchione, FDA's director of psychiatric drugs, in a statement.

Postpartum depression affects an estimated 400,000 people a year, and while it often ends on its own within a couple of weeks, it can continue for months or even years.

Standard treatment includes counselling or antidepressants, which can take weeks to work and don’t help everyone.

The new pill is from Sage Therapeutics, which has a similar infused drug that’s given intravenously over three days in a medical facility. The FDA approved that drug in 2019, though it isn’t widely used because of its $34,000 price tag and the logistics of administering it.

The FDA's pill approval is based on two company studies that showed women who took Zurzuvae had fewer signs of depression over a four- to six-week period when compared with those who received a dummy pill.

The benefits, measured using a psychiatric test, appeared within three days for many patients.

What happens after 45 days?

Dr. Kimberly Yonkers of Yale University said the Zurzuvae effect is “strong” and the drug likely will be prescribed for women who haven’t responded to antidepressants. She wasn't involved in testing the drug.

Still, she said, the FDA should have required Sage to submit more follow-up data on how women fared after additional months.

“The problem is we don’t know what happens after 45 days,” said Yonkers, a psychiatrist who specialises in postpartum depression. “It could be that people are well or it could be that they relapse.”

Sage did not immediately announce how it would price the pill, and Yonkers said that'll be a key factor in how widely its prescribed.

Side effects with the new drug are milder than the IV version, and include drowsiness and dizziness. The drug was co-developed with fellow Massachusetts pharmaceutical company Biogen.

Sage's drugs are part of an emerging class of medications dubbed neurosteroids. These stimulate a different brain pathway than older antidepressants that target serotonin, the chemical linked to mood and emotions.