Brexanolone (Zulresso) was the first drug FDA-approved for postpartum depression (2019). It is a neuroactive steroid given as a 60-hour IV infusion in a certified facility for moderate-to-severe PPD, with rapid onset.
Class
Neuroactive steroid (IV)
Educational information, not medical advice. This page summarizes published research and public-health guidance for learning purposes. It is not a substitute for diagnosis or treatment by a qualified clinician. If you are struggling, talk to your doctor or midwife. In a crisis, call or text 988 or the Maternal Mental Health Hotline at 1-833-852-6262.
Evidence snapshot — computed from live data
174
Studies indexed (PubMed)
moderate evidenceStrength score 56/100
Overview
- Class: neuroactive steroid (IV)
- Typical use: moderate-to-severe PPD
- Administration: 60-hour monitored IV infusion at a certified center
- Onset: rapid—often within the infusion period
Breastfeeding considerations
First drug FDA-approved for PPD (2019); 60-hour IV infusion under supervision.
Breastfeeding decisions are always individual — make them with your prescriber.
Compare SSRI options in our breastfeeding-safety comparison.
Sources & further reading
Selected recent peer-reviewed studies, pulled live from the U.S. National Library of Medicine (PubMed). Counts and citations update automatically.
- Dargan TL et al. “Potential of Neurosteroids for Precision Medicine in Psychiatry.” Biological psychiatry (2026). PubMed →
- Xie G et al. “Real-world adverse event profiles of Zuranolone and Brexanolone based on FAERS and VigiAccess databases: An observational study.” Medicine (2026). PubMed →
- Xiao Y et al. “Comparative efficacy and acceptability of pharmacological interventions for postpartum depression: a systematic review and network meta-analysis.” Psychiatry research (2026). PubMed →
- Ok HI et al. “First Reported Case of Dissociative Symptoms Associated With Zuranolone Use in Peripartum Depression.” Cureus (2026). PubMed →
- Lyu G et al. “Innovations in Depression Diagnosis and Treatment: A Review of Biological, Cognitive, and Psychosocial Advances.” Current topics in medicinal chemistry (2026). PubMed →
