Scott Alexander examines Zulresso and Zuranolone, two neurosteroid drugs for postpartum depression, discussing their efficacy, challenges, and potential future applications. Longer summary

Scott Alexander discusses Zulresso (allopregnanolone) and Zuranolone, two related drugs for treating postpartum depression. He explains their mechanisms, efficacy, and the challenges in their development and usage. The post covers the history of allopregnanolone research, its connection to GABA and hormones, clinical trials, and potential future applications. Scott also discusses the high cost of Zulresso, its limited availability, and the mixed results of Zuranolone in treating regular depression and anxiety. The post ends with predictions about the future of these drugs and related research. Shorter summary

Scott Alexander critiques the FDA approval of esketamine for depression, discussing issues with drug development, efficacy, cost, and administration requirements. Longer summary

This post discusses the FDA's approval of esketamine for treatment-resistant depression, highlighting the issues with the pharmaceutical industry's approach to drug development and approval. Scott Alexander explains how companies often make minor changes to existing chemicals to patent them, as in the case of esketamine (a left-handed version of ketamine). He critiques the high cost of esketamine compared to regular ketamine and the FDA's stringent requirements for its administration. The post also questions the efficacy of esketamine based on clinical trials and discusses the inconvenience of the approved delivery method. Scott expresses disappointment that this approval may set a precedent for future psychedelic medicines, making them equally inconvenient and bureaucratic to access. Shorter summary