Zuranolone
Neurosteroid antidepressants
Neurosteroid antidepressants
An oral neurosteroid antidepressant taken as a short course for postpartum depression. It impairs alertness, so no driving for 12 hours after each dose.
Quick facts
- Group
- Neurosteroid antidepressants
- Target
- GABA-A receptor (neurosteroid site)
- Used for
- Postpartum depression in adult women
- Key effects
- Drowsiness · Diarrhoea · Cold-like symptoms
- Monitor
- Drowsiness and confusion · Mood and suicidal thoughts
- ATC
- N06AX31
No doses: the clinician sets them by the current guideline.
Mechanism of action
No zuranolone-bound structure is available. The figure shows allopregnanolone (brexanolone), the natural neurosteroid of the same class, in the human GABA-A receptor.
Zuranolone belongs to the neurosteroid antidepressants, the class of brexanolone. These neuroactive steroids enhance GABA-A receptor function, increasing inhibitory chloride currents. Unlike brexanolone it is taken by mouth, which allows a short course at home, but the same action causes drowsiness, dizziness and confusion.
- Zuranolone is an oral neurosteroid
- It enhances GABA-A receptor function
- Restores inhibitory tone: relief of postpartum depression
- Same action impairs alertness and driving
Indications
- Postpartum depression in adult women Perinatal depression and postpartum psychosis →
Adverse effects
Common
- Drowsiness, dizziness and lack of energy
- Diarrhoea, dry mouth
- Cold-like symptoms (stuffy nose, sore throat)
- Muscle pain or twitching
Contraindications
- Hypersensitivity to zuranolone
Key interactions
- Alcohol, benzodiazepines, opioids and other CNS depressants
- More sedation, dizziness and confusion
- St John's wort
- Interaction; avoided unless discussed with the treating team
- Grapefruit or grapefruit juice
- May change zuranolone levels; discussed with the treating team
What is monitored
- Drowsiness and confusion
- Mood and suicidal thoughts
- Use of alcohol or other sedatives
Administration and safety
- Taken in the evening with a fat-containing meal
- No driving or dangerous activities for at least 12 hours after each dose
Pregnancy and breastfeeding
Effective contraception is advised during treatment and for one week after the last dose; data on breastfeeding are limited.
Nursing care
- Teaches that driving is not safe for at least 12 hours after each dose, even if the patient feels alert
- Asks about alcohol and other sedating medicines
- Advises effective contraception during treatment and for one week after
- Asks about mood, suicidal thoughts and falls
Pharmacokinetics
- Absorption
- By mouth in the evening, with food that contains fat
Test yourself
Think of the answer, then tap the question to see it.
How does zuranolone differ from brexanolone in administration?
Zuranolone is taken by mouth as a short course; brexanolone is a continuous IV infusion in a facility.
What does the boxed warning of zuranolone say about driving?
No driving or other dangerous activities for at least 12 hours after each dose.
For which condition is zuranolone used?
Postpartum depression in adult women.
Connections
← Back to the class: Neurosteroid antidepressants
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Zuranolone: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.