Zuranolone: What to know about the pill for postpartum depression
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In the year after giving birth, about one in eight people who give birth in the U.S. experience the debilitating symptoms of postpartum depression (PPD), including lack of energy and feeling sad, anxious, hopeless, and overwhelmed.
Postpartum depression is a serious, potentially life-threatening condition that can affect a person’s bond with their baby. Although it’s frequently confused with the so-called “baby blues,” it’s not the same.
The baby blues include similar, temporary symptoms that affect up to 80 percent of people who have recently given birth and usually go away within the first few weeks. PPD usually begins within the first month after giving birth and can last for months and interfere with a person’s daily life if left untreated. Thankfully, PPD is treatable and there is help available.
On August 4, the FDA approved zuranolone, branded as Zurzuvae, the first-ever oral medication to treat PPD. Until now, besides other common antidepressants, the only medication available to treat PPD specifically was the IV injection brexanolone, which is difficult to access and expensive and can only be administered in a hospital or health care setting.
Read on to find out more about zuranolone: what it is, how it works, how much it costs, and more.
What is zuranolone?
Zurzuvae is the brand name for zuranolone, an oral medication to treat postpartum depression. Developed by Sage Therapeutics in partnership with Biogen, it’s now available in the U.S. Zurzuvae is typically prescribed as two 25 mg capsules a day for 14 days. In clinical trials, the medication showed to be fast-acting, improving PPD symptoms in just three days.
How does zuranolone work?
Zuranolone is a neuroactive steroid, a type of medication that helps the neurotransmitter GABA’s receptors, which affect how the body reacts to anxiety, stress, and fear, function better.
“Zuranolone can be thought of as a synthetic version of [the neuroactive steroid] allopregnanolone,” says Dr. Katrina Furey, a reproductive psychiatrist, clinical instructor at Yale University, and co-host of the Analyze Scripts podcast. “Women with PPD have lower levels of allopregnenolone compared to women without PPD.”
How is it different from other antidepressants?
“What differentiates zuranolone from other previously available oral antidepressants is that it has a much more rapid response and a shorter course of treatment,” says Dr. Asima Ahmad, an OB-GYN, reproductive endocrinologist, and founder of Carrot Fertility.
“It can take effect as early as on day three of treatment, versus other oral antidepressants that can take up to six to 12 weeks to take full effect.”
What are Zurzuvae’s side effects?
According to the FDA, the most common side effects of Zurzuvae include dizziness, drowsiness, diarrhea, fatigue, the common cold, and urinary tract infection. Similar to other antidepressants, the medication may increase the risk of suicidal thoughts and actions in people 24 and younger. However, NPR noted that this type of labeling is required for all antidepressants, and researchers didn’t see any reports of suicidal thoughts in their trials.
“Drug trials also noted that the side effects for zuranolone were not as severe,” says Ahmad. “[There was] no sudden loss of consciousness as seen with brexanolone or weight gain and sexual dysfunction, which can be seen with other oral antidepressants.”
She adds: “Given the lower incidence of side effects and more rapid-acting onset, zuranolone could be a viable option for many,” including those looking for a treatment that offers faster symptom relief.
Can someone breastfeed while taking zuranolone?
It’s complicated. In clinical trials, participants were asked to stop breastfeeding (which, according to Furey, is common in early clinical trials).
A small study of people who were nursing while taking zuranolone found that 0.3 percent of the medication dose was passed on to breast milk, which, Furey says, is a pretty low amount of exposure for the baby. Ahmad says that “though some data suggests that the risk of harm to the baby may be low, there is still overall limited data.”
Overall, people should talk to their health care provider about the risks and benefits of breastfeeding while on the medication.
“A lot of factors will need to be weighed, such as overall health of the infant, age of the infant, etc., when making this decision,” Furey says.
How much does Zurzuvae cost?
Zurzuvae’s price before insurance coverage is $15,900 for the 14-day treatment. However, the Policy Center for Maternal Mental Health says insurance companies and Medicaid are expected to cover it because it’s the only drug of its kind.
Less than 1 percent of U.S. insurers have issued coverage guidelines so far, so it’s still unknown how much it will cost patients after insurance. Some insurers require patients to try another antidepressant first (like the more common SSRIs) before covering Zurzuvae. For uninsured and underinsured people, Sage Therapeutics said it will offer copay assistance.
The hefty price tag and potential issues with coverage may widen existing health disparities, says Ahmad. “We need to ensure that we are seeking out solutions to enable wide-scale access to all PPD treatments so that people have access to whatever treatment may work best for them.”
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Put Your Feet Up! (Against A Wall, For 20 Minutes)
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Feel free to browse our articles while you do
Here are 10 good reasons to give it a try; there are another 10 in the short (3:18) video:
- Improves blood circulation
- Improves blood pressure
- Relaxes the body as a whole
- Alleviates lower back tension
- Eases headaches and migraines
- Reduces knee pain
- Relieves swelling in feet and ankles
- Improves lymphatic flow
- Stretches the hamstrings (and hip flexors, if you do it wide)
- Helps quiet the mind
As for the rest…
Click Here If The Embedded Video Doesn’t Load Automatically
PS: about that circulation… As a general rule of thumb, anything that slightly confuses the heart (anatomically, not romantically) will tend to have a beneficial effect, in moderation. This goes for being upside-down (as is partly the case here), and also for high-intensity interval training (HIIT):
How To Do HIIT (Without Wrecking Your Body)
Take care!
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Learning to Love Midlife – by Chip Conley
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While the book is titled about midlife, it could have said: midlife and beyond.
Some of the benefits discussed in this book really only kick in during one’s 50s, 60s, or 70s, usually. Which, for all but the most optimistic, is generally considered to be stretching beyond what is usually called “midlife”.
However! Chip Conley makes the argument for midlife being anywhere from one’s early 30s to mid-70s, depending on what (and how) we’re doing in life.
He talks about (as the subtitle promises) 12 reasons life gets better with age, and those reasons are grouped into 5 categories, thus:
- Physical life
- Emotional life
- Mental life
- Vocational life
- Spiritual life
It may surprise some readers that there are physical benefits that come with aging, but we do get two chapters in that category.
The writing style is very casual, yet with references to science throughout, and a bibliography for such.
Bottom line: if you’d like to make sure you’re making the most of your midlife and beyond, this a book that offers a lot of guidance on doing so!
Click here to check out Learning to Love Midlife, and age in style!
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Cottage cheese is back and all over TikTok. Two dietitians explain why social media’s obsessed
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You might remember cottage cheese from your childhood. Back then, it was considered “diet food”. You ate it out of the tub, with celery or spread it on crackers for a low-calorie snack. Then cottage cheese went out of fashion.
But cottage cheese is having a resurgence. In recent months, Google searches for “cottage cheese” have risen to the highest levels since 2004.
Social media influencers have been promoting its benefits on TikTok and Instagram with hashtags such as #cottagecheese, #cottagecheeseforlife, and #cottagecheeserecipe. Sales of cottage cheese around the world have skyrocketed.
Let’s see why cottage cheese is having such a moment.
Karolina Kaboompics/Pexels What is cottage cheese?
Cottage cheese is a fresh dairy cheese product with a mild flavour and a slightly tangy taste. It is made by curdling cow’s milk, then draining the whey, leaving behind the curds. These curds are usually small and lumpy, and the texture can vary from creamy to dry, depending on the amount of whey left in the cheese.
The term “cottage cheese” is said to have originated because the cheese was generally made in cottage-type houses from leftover milk, after making butter.
Cottage cheese is cheap, costing about A$12 per kilogram in the supermarket, similar to ricotta cheese.
It’s also surprisingly simple to make at home using freely available recipes. All you need is milk, salt and a splash of vinegar.
We’re using cottage cheese in new ways
It’s difficult to know what started the latest cottage cheese trend. But the creativity of social media means people are sharing alternative ways to use cottage cheese, changing people’s views from it being boring and lacking flavour to it being versatile and healthy.
People are spreading cottage cheese on toast and using it to make dishes such as porridge, dips, salads, bread and flatbreads. They’re using it in cakes and scones, and in desserts such as mousse and ice cream.
Is cottage cheese healthy?
Compared with other cheeses, cottage cheese is low in fat and therefore energy (kilojoules or kJ). This makes it a smart choice for people looking to cut down on their daily energy intake.
For example, 100 grams of cottage cheese contains about 556kJ. The same amount of cheddar contains 1,254kJ and parmesan 1,565kJ.
Many cheeses are rich in protein but they often contain higher amounts of kilojoules due to their fat content. But cottage cheese has substantial amounts of protein with fewer kilojoules.
This makes cottage cheese an ideal option for people aiming to maximise their protein intake without eating large amounts of kilojoules.
Some 100g of cottage cheese provides 17g protein. This is about the same found in three eggs, 60g chicken breast or 320 millilitres (about 300g) full-fat yoghurt.
People are sharing images of their cottage cheese creations on TikTok and Instagram. New Africa/Shutterstock Cottage cheese also contains high levels of vitamin B12 (important for healthy brain function), riboflavin (supports healthy skin and eyes), phosphorus (helps build strong bones and teeth) and folate (essential for cell growth).
However, cottage cheese is lower in calcium compared with other cheeses. It contains just 89 milligrams per 100g. This compares with parmesan (948mg), haloumi (620mg) and ricotta (170mg).
You’ve convinced me. How can I use cottage cheese?
Beyond its excellent nutrition profile, the resurgence of cottage cheese is enabling people to experiment in the kitchen. Its neutral flavour and varied textures – ranging from smooth to chunky – makes it suitable for a range of dishes, from sweet to savoury.
TikTok and Instagram have some great recipes. You could start with an old faithful recipe of celery and cottage cheese, and work your way towards new options such as cottage cheese ice cream.
The healthiest recipes will be those that combine cottage cheese with wholefoods such as fruits, vegetables, nuts and seeds, and lean protein sources.
For instance, you can make a cottage cheese wrap then fill it with vegetables and a lean source of protein (such as chicken or fish).
Other combinations include cottage cheese salad dressings, vegetable dips and egg salads.
Cottage cheese’s rise in popularity is well deserved. Including more cottage cheese in your diet is a smart choice for getting a high dose of protein without adding processed ingredients or too much energy. Embrace the trend and get creative in the kitchen.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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We Hope This Email Blows Your Tits Clean Off
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The Right Kind Of “Email Hacks”!
Are you a Gmailer or an Outlookista? Whatever your preference, you’re probably facing many of the same challenges that most of us face in our work and personal lives:
Email’s greatest strength (its ease of accessibility) brings about its greatest problem (our inboxes are cluttered and chaotic), not to mention that each of us are usually managing a whole flock of email addresses.
Sometimes we put productivity resources up against each other; that’s not what we’re going to do today! Each of these can play a role alongside each other; grab as many as will make your life easier:
ProtonMail: this is an email client; it’s the nicest, simplest, easiest, free email client that doesn’t track, let alone share, everything you do.
Bonus: there also exists ProtonCalendar (it’s a calendar that doesn’t share your data), ProtonDrive (it’s a cloud storage provider that doesn’t share your data) and, because they’re indeed serious about your privacy, ProtonVPN (it’s a VPN that, of course, doesn’t share your data).
Clean Email: maybe you’re stuck with the email provider you have. It happens. But it doesn’t have to be a chaotic mess. This tool will make tidying your email (and keeping it tidy!) a simplified dream.
See How Clean Your Email Can Get With Just A Few Clicks!
Right Inbox: a Gmail extension with many useful features, including read receipts, emails scheduled for later (e.g: time your email to send at 7am to look like a morning lark when in fact you’re peacefully snoozing), add unforwardable “For Your Eyes Only” notes to emails, and more.
Power Up Your Gmail With The Right Inbox Extension!
Email Finder: find the verified work email address of any person, so long as you know what company you’re looking for them in! No more “I thought it was lastname.firstname@ and it was firstname.lastname@”, no more “the wrong John Smith”, no more “undelivered” bounceback notices. Just: your email delivered.
Never Hear From The Mailer Daemon Again, With Email Finder!
Unroll.me: love your subscriptions, but hate the clutter? Unroll.me aggregates them for you in a virtual roll-up, with an “unroll” button to read them.
Get What You Really Want From Your Subscriptions, With Unroll.Me!
On which note, anything you’d like to hear more of from us? Let us know! You can always just hit reply, or use the feedback widget at the bottom of this email
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Nine Pints – by Rose George
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Rose George is not a scientist, but an investigative journalist. As such, she’s a leave-no-stone-unturned researcher, and that shows here.
The style throughout is, as one might expect, journalistic. But, she’s unafraid of diving into the science of it, interviewing many medical professionals as part of her work. She also looks to people living with various blood-related conditions, ranging from hemophilia to HIV.
Speakling of highly-stigmatized yet very manageable conditions, there’s also a fair section devoted to menstruation, menstrual blood, and societies’ responses to such, from shunning to active support.
We also learn about the industrialization of blood—from blood banks to plasma labs to leech farms. You probably knew leeches are still used as a medical tool in even the most high-tech of hospitals, but you’ll doubtlessly learn a fascinating thing or two from the “insider views” along the way.
Bottom line: if you’d like to know more about the red stuff in all its marvelous aspects, with neither sensationalization nor sanitization (the topic needs neither!), this is the book for you.
Click here to check out Nine Pints, and learn more about yours!
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Reduce Your Skin Tag Risk
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝As I get older, I seem to be increasingly prone to skin tags, which appear, seemingly out of nowhere, on my face, chest and back. My dermatologist happily burns them off – but is there anything I can do to prevent them?!❞
Not a lot! But, potentially something.
The main risk factor for skin tags is genetic, and you can’t change that in any easy way.
The other main risk factors are connected to each other:
Skin folds, and chafing
Skin tags mostly appear where chafing happens. This can be, for example:
- Inside joint articulations (especially groin and armpits)
- Between fat rolls (if you have them)
So, if you have fat rolls, then losing weight will also reduce the risk of skin tags.
Additionally, obesity and some often-related problems such as diabetes, hypertension, and an atherogenic lipid profile also increase the risk of skin tags (amongst other more serious things):
See: Association of Skin Tag with Metabolic Syndrome and its Components
As for the chafing, this can be reduced in various ways, including:
- losing weight if (and only if) you are carrying excess weight
- dressing against chafing (consider your underwear choices, for example)
- keeping hair in the armpits and groin (it’s part of what it’s there for)
See also: Simply The Pits: These Underarm Myths!
Take care!
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