New Treatment Option for Postnatal Depression Faces UK Access hurdles
A new medication, zuranolone, has received approval from teh Medicines and Healthcare products Regulatory Agency (MHRA) in August 2025 for the treatment of moderate to severe postnatal depression (PND) in adults. This marks a potential turning point, as currently no medications in the UK are specifically licensed for perinatal mental health conditions.
Zuranolone is a synthetic form of allopregnanolone, a neuroactive steroid naturally produced in the body.Allopregnanolone levels fluctuate dramatically during and after pregnancy, with a sharp decline post-delivery potentially contributing to the growth of PND in some women.
Unlike conventional antidepressants that require weeks of consistent use to demonstrate effect, zuranolone is administered as a 14-day course, with some patients reporting improvements within three days. This rapid action offers a potentially significant benefit for women experiencing severe distress.
However, access to zuranolone in the UK is currently uncertain. While approved by the MHRA, the National Institute for Health and Care Excellence (NICE) is evaluating its cost-effectiveness. In draft guidance released in August 2025, NICE currently does not recommend routine use of the drug, primarily due to its high cost – a course currently priced around US$16,000 in the United States – and limited data on the long-term duration of its benefits, as studies to date have followed patients for relatively short periods. A final decision from NICE is anticipated in October 2025.
Further considerations surround the use of zuranolone while breastfeeding.Preliminary data suggest minimal transfer into breast milk, but the evidence base remains limited, and some experts recommend temporarily pausing breastfeeding during treatment.
Despite these hurdles, the potential of zuranolone is significant. Suicide remains a leading cause of maternal death in the UK, and rapid-acting treatments could provide crucial support for women in crisis.
Pharmacists are poised to play a vital role in the potential implementation of zuranolone. They are often well-positioned to identify early signs of PND and anxiety, offer non-judgmental support, and connect women and families with appropriate local resources. Should zuranolone become available, pharmacists will be key in educating patients about its mechanism, expected benefits and side effects, and its compatibility with breastfeeding and other medications. Crucially,they can also contribute to destigmatizing perinatal mental health by fostering open and routine conversations.James Lee,lead pharmacist,specialist community perinatal mental health service,Devon Partnership NHS Trust
