Overview of acute treatment for severe postpartum unipolar major depression^*

ECT: electroconvulsive therapy; SSRI: selective serotonin reuptake inhibitor.

* Severe episodes of unipolar major depression (major depressive disorder) are generally characterized by 7 to 9 depressive symptoms, including dysphoria and/or anhedonia; symptoms occur nearly every day for at least 2 weeks.

Treatment usually entails pharmacotherapy or neuromodulation, and psychotherapy is nearly always indicated. The duration of an adequate treatment trial is generally 6 to 12 weeks. Refer to the UpToDate treatment topic for full details of treatment, including treatment for psychotic depression, anxiety, and insomnia, as well as the evaluation of patients for maintenance treatment.

¶ Zuranolone is generally prescribed at a dose of 50 mg each evening for 14 days. Response is evaluated after the 14-day trial.

Δ Response is often usually defined as improvement of baseline symptoms >50%, partial response as improvement by 25 to 49%, and little to no response as improvement <25%.