zuranolone

Adjunctive therapy

Brands: Zurzuvae

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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Quick answers

What is zuranolone?
Zuranolone (brand Zurzuvae) is a neuroactive steroid and GABA-A receptor positive allosteric modulator approved for postpartum depression (PPD) in adults (label).
What is Zurzuvae?
Zurzuvae is a brand name for zuranolone.
What is Zurzuvae (zuranolone) used for?
Label indications include: Postpartum depression (adults) (label).
What drug class is Zurzuvae (zuranolone)?
Neuroactive steroid and GABA-A receptor positive allosteric modulator. FDA-approved as a 14-day oral treatment course for postpartum depression (label).
What strengths does Zurzuvae (zuranolone) come in?
Oral capsules (label): 20 mg, 25 mg, 30 mg.

Snapshot

Class: Adjunctive therapy
Common US brands: Zurzuvae
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Label indications

Postpartum depression (adults) (label).

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Clinical Highlights

Zuranolone (brand Zurzuvae) is a neuroactive steroid and GABA-A receptor positive allosteric modulator approved for postpartum depression (PPD) in adults (label). The labeled course is short (14 days) and taken in the evening with fat-containing food. Clinical trials show symptom improvement versus placebo during the treatment course, with follow-up extending beyond the dosing window (label/trial).

Zuranolone carries a boxed warning for driving impairment due to CNS depressant effects. Counseling includes avoiding driving and other hazardous activities until at least 12 hours after each dose (label).
It is a controlled substance (Schedule IV; “CIV” on label) and has potential for physical dependence and withdrawal symptoms if used at higher doses or longer duration than recommended (label).
The compare view, zuranolone evidence feed, and zuranolone print page help frame postpartum depression treatment options when rapid symptom change and functional safety (sedation/driving) are central concerns.

Dosing & Formulations

Recommended dosage is 50 mg orally once daily in the evening for 14 days, taken with fat-containing food (label). If CNS depressant effects occur, labeling allows dose reduction to 40 mg once daily within the 14-day course (label).

Dose reductions are required in severe hepatic impairment, moderate to severe renal impairment, and when used with strong CYP3A4 inhibitors (label).
Capsules are available in 20 mg, 25 mg, and 30 mg strengths, combined to make the prescribed daily dose (label).

Monitoring & Risks

Boxed warning: impaired ability to drive or engage in potentially hazardous activities due to CNS depressant effects; avoid driving until at least 12 hours after dosing (label). Sedation, somnolence, dizziness, and confusion can occur; risk is higher with alcohol or other CNS depressants (label).

Suicidal thoughts and behavior are a labeled warning; monitoring for mood worsening and suicidality is part of standard depression care (label/clinical).
Embryo-fetal risk: based on animal data, the label warns that zuranolone may cause fetal harm when administered during pregnancy (label).

Drug Interactions

Alcohol and other CNS depressants (including benzodiazepines) can worsen psychomotor impairment and sedation; counseling often emphasizes avoidance during treatment (label). Strong CYP3A4 inhibitors increase exposure and require dose reduction; strong CYP3A4 inducers can reduce exposure and are avoided (label).

Practice Notes

Zuranolone can be used alone or as an adjunct to oral antidepressant therapy, and follow-up often focuses on function and safety after the 14-day course ends (label/clinical). Because postpartum depression treatment decisions often involve infant feeding, sleep disruption, and caregiver support, clinicians commonly pair medication decisions with practical support planning (clinical).

Because the course is time-limited, many clinicians schedule follow-up near the end of treatment (or shortly after) to plan ongoing postpartum depression care and assess relapse risk (clinical).

References

ZURZUVAE (zuranolone) capsules prescribing information — DailyMed (2026)
Effect of Zuranolone vs Placebo in Postpartum Depression: A Randomized Clinical Trial — JAMA Psychiatry (2021)
Zuranolone for the Treatment of Postpartum Depression — The American Journal of Psychiatry (2023)
Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development — CNS Drugs (2019)