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Meta-Analysis
. 2024 Dec 4:46:e-rbgo79.
doi: 10.61622/rbgo/2024rbgo79. eCollection 2024.

Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies

Juliana Almeida Oliveira  1 , Karine Eskandar  2 , Marcos Aurélio Araújo Freitas  3 , Chris Elizabeth Philip  4
Affiliations
Meta-Analysis

Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies

Juliana Almeida Oliveira et al. Rev Bras Ginecol Obstet. .

Abstract

Objective: To evaluate the maternal outcomes in women with postpartum depression using zuranolone, the first oral medication indicated to treat postpartum depression.

Methods: We conducted a systematic search in September 2023, on Pubmed, Embase and Cochrane Trials. We included randomized controlled trials comparing the effectiveness and safety of zuranolone versus placebo in women with postpartum depression. No time or language restrictions were applied. 297 results were retrieved, of which 11 papers were selected and fully reviewed by two authors. Review Manager 5 was used for statistical analysis and Cochrane Risk-of-bias tool for randomized trials was applied for quality assessment.

Results: We included 2 studies, with 346 women, of whom 174 (50.2%) were treated with zuranolone. Zuranolone was significantly associated to an improvement of Clinical Global Impression response rate; Hamilton Depression Rating Scale 15 days and 45-day remission, 3-day, 15-day, and 45-day symptom remission, and reduction in the dose of antidepressants. As for safety outcomes, it was noticed that zuranolone increases sedation risk, which can be dose related. No significant differences were found for other adverse events.

Conclusion: These findings suggest that zuranolone might present a safe and effective medication for out-of-hospital treatment of PPD. Sedation effects need to be further assessed.

Keywords: Major depressive disorder; Postpartum depression; Synthetic neurosteroid; Zuranolone.

PubMed Disclaimer

Conflict of interest statement

Conflicts to interest: none to declare.

Figures

Figure 1
Figure 1. Flow diagram of the screening process
Figure 2
Figure 2. The CGI response rate was higher in the zuranolone group
Figure 3
Figure 3. The delta in HAM-D score from baseline was significantly more favorable in the zuranolone group at both 15-days (A) and 45-days (B)
Figure 4
Figure 4. Remission of PPD symptoms was higher in the zuranolone group at 3 days (A), 15 days (B) and 45 days (C)
Figure S1
Figure S1. A reduction in the dose of antidepressant therapy was more common in the zuranolone group.
Figure S2
Figure S2. Sedation was significantly more common in the zuranolone group.
Figure S3
Figure S3. Forest plot of summary of crude ORs and 95% CIs for diarrhea for zuralonone versus placebo
Figure S4
Figure S4. Forest plot of summary of crude ORs and 95% CIs for dizziness for zuralonone versus placebo
Figure S5
Figure S5. Forest plot of summary of crude ORs and 95% CIs for headache for zuralonone versus placebo
Figure S6
Figure S6. Forest plot of summary of crude ORs and 95% CIs for nausea for zuralonone versus placebo
Figure S7
Figure S7. Forest plot of summary of crude ORs and 95% CIs for somnolence for zuralonone versus placebo
Figure S8
Figure S8. Forest plot of summary of crude ORs and 95% CIs for Upper respiratory tract infection for zuralonone versus placebo
Figure S9
Figure S9. ROB-2
See this image and copyright information in PMC

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