WHA
 

Zurzuvae (zuranolone)

Indications for Prior Authorization

Zurzuvae (zuranolone)
  • For diagnosis of Postpartum Depression (PPD)
    Indicated for the treatment of PPD in women 18 years of age and older

Criteria

Zurzuvae

Prior Authorization

Length of Approval: 14 Day(s)

  • One of the following:
    • Diagnosis of moderate to severe postpartum depression (PPD)
      • OR
    • Both of the following:
      • Diagnosis of mild postpartum depression (PPD)
        • AND
      • Trial and failure, contraindication or intolerance to at least one oral SSRI or SNRI (e.g., escitalopram, duloxetine)
    AND
  • Patient is 18 years of age or older
    • AND
  • Onset of symptoms in the third trimester or within 4 weeks of delivery
    • AND
  • Prescriber attests that the patient has been counseled and has agreed to adhere to the following: Will follow instructions to not drive or operate machinery until at least 12 hours after taking each dose of Zurzuvae for the duration of the 14-day treatment course and that patients are informed that they may not be able to assess their own driving competence or the degree of driving impairment caused by Zurzuvae

  • Guideline ID
    GL-483952

  • Formulary
    Premium

  • Effective date
    Mar 1, 2026

  • P&T approval date
    Jan 17, 2024

P & T Revisions

2026-01-06, 2025-12-18, 2025-12-18, 2025-01-20, 2024-09-19, 2024-01-04

  1. Zurzuvae Prescribing Information. Biogen MA Inc. Cambridge, MA. July 2024.
  2. American College of Obstetricians and Gynecologists (ACOG), Committee on Clinical Practice Guidelines - Obstetrics. Clinical practice guideline no. 5: Treatment and management of mental health conditions during pregnancy and postpartum. Obstet Gynecol. 2023;141(6):1262-1288.
  3. Clinical consult with obstetrician/gynecologist. October 26, 2023.
  4. Clinical consult with psychiatric pharmacist. October 30, 2023.
  1. American College of Obstetricians and Gynecologists (ACOG) clinical practice guidelines recommend psychotherapy and either SSRIs or SNRIs as first-line treatment for mild-to-moderate perinatal depression, although the specific choice of therapy may depend on the patient’s treatment history and other factors. Per clinical consults with an obstetrician/gynecologist and a psychiatric pharmacist from October 2023, if depression was mild or low-moderate, patient could begin treatment with supportive care and an SSRI or SNRI without a referral to a mental health provider.
  • 2026-01-06: 2026 Annual Review. No criteria changes. Added endnote and updated references.
  • 2025-12-18: No criteria changes
  • 2025-12-18: no criteria changes, added IL statute operational note
  • 2025-01-20: 2025 annual review. No clinical changes.
  • 2024-09-19: Removal of trial requirement for moderate PPD to support formulary strategy.
  • 2024-01-04: New Program