Advances in the treatment of postpartum depression: comparison between new antidepressants and traditional therapies

Abstract

Postpartum depression (PPD) is a mood disorder associated with the puerperium and has important consequences for maternal health, mother-infant bonding, and family functioning. Although psychotherapy and traditional antidepressants remain widely used, clinical response may be slow or insufficient in some cases. In this context, brexanolone and zuranolone emerge as neurosteroids whose mechanism of action is related to GABA_A receptor modulation and a faster onset of effect. This is an integrative literature review developed using the PICO strategy, with women with PPD as the population, new antidepressants as the intervention, traditional therapies as the comparison, and efficacy and safety as outcomes. The search was conducted in PubMed using the descriptors postpartum depression, antidepressants, zuranolone, and brexanolone, combined with AND and OR, including studies published between 2020 and 2025. The findings indicate that zuranolone produced significant improvement in depressive symptoms and good tolerability, whereas brexanolone showed relevant efficacy but was limited by intravenous administration, the need for monitoring, and higher cost. In conclusion, the new antidepressants represent an important advance in PPD treatment, although further studies are still needed regarding long-term safety, access, and applicability across different care settings.