Comparative efficacy and acceptability of pharmacological interventions for postpartum depression: a systematic review and network meta-analysis.
Psychiatry research July 1, 2026 Yao Xiao, Ping Xie, Danlei Li et al.
A network meta-analysis of 18 randomized controlled trials (1722 participants) compared pharmacological treatments for postpartum depression. Compared with placebo, saffron, fluoxetine, esketamine, brexanolone, and zuranolone showed signals of improvement in depressive symptom severity. Fluoxetine, saffron, and zuranolone were associated with higher response rates, though estimates for fluoxetine and saffron were imprecise. Brexanolone was the only intervention showing a statistically significant improvement in remission, but it may have a potentially unfavourable acceptability signal based on all-cause discontinuation. Zuranolone was associated with an increased incidence of adverse events. The evidence is limited by sparse networks, imprecision, and clinical heterogeneity, so findings should be interpreted cautiously.