By Pam Belluck
Pam Belluck, who covers maternal mental health, visited and talked with women across the country who experienced postpartum depression.
Some women’s symptoms improved quickly after taking the pill, but depression persisted in others. Doctors are trying to learn which patients benefit, and why some don’t.
Depression descended on Samantha Cohn about two months after her baby boy was born.
He was thriving, but she became convinced she was a terrible mother. “I felt like I wasn’t doing enough, I wasn’t doing anything right,” she said. She began to think her son and husband might be better off without her. When the baby was about 5 months old, she tried to take her life with a gun.
Ms. Cohn, 30, who lives near Fayetteville, N.C., was hospitalized for weeks and underwent surgeries to repair damage to her jaw, nose, tongue and face. But her postpartum depression remained challenging to treat. The hospital’s maternal mental health specialists decided to have her try a medication that had recently become available: the first pill specifically for postpartum depression.
Clinical trials had found that the drug, zuranolone, marketed as Zurzuvae and taken daily for 14 days, can ease symptoms for some women in as little as three days, while general antidepressants can take weeks. For Ms. Cohn, its impact was swift and striking. On her fourth day of taking it, she said she suddenly “felt so much clarity in my head, like I didn’t have nagging thoughts about not being good enough.”
Now, a year and a half after the drug became available, thousands of women have tried it, and their experiences have run the gamut. For some, symptoms improved remarkably. Others described a modest benefit that didn’t last or said their depression persisted. And others didn’t complete the two-week regimen because profound drowsiness, a common side effect of the drug, interfered with their ability to care for their babies or to fulfill other responsibilities.
One in eight women in the United States experiences depression during pregnancy or in the year after giving birth, the Centers for Disease Control and Prevention estimates, and effective treatments are crucially needed. While the fast-acting pill shows promise, doctors say the challenge now is to determine which patients will benefit and why some don’t.
Clinical trials of the drug found that postpartum depression improved in about 60 percent of patients. “It’s not everyone,” Dr. Samantha Meltzer-Brody, a leader of the trials and director of the Center for Women’s Mood Disorders at the University of North Carolina at Chapel Hill, said at a National Institutes of Health conference. “So, what is it about the people that are going to respond versus those that don’t?”