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 examines the rise, fall, and alleged resurrection of the antidepressant NSI-189, expressing skepticism about its efficacy and the broader challenges in developing new antidepressants. Longer summary

Scott Alexander discusses the disappointing results of NSI-189, a promising new antidepressant, in FDA trials. He explains how the drug initially failed to outperform placebo on the primary endpoint, leading to a stock crash for Neuralstem. However, the company later released positive secondary endpoint results, causing their stock to rise again. Scott expresses skepticism about these new results, suggesting they may be due to statistical manipulation rather than true efficacy. He reflects on the challenges of developing new antidepressants and the tendency to get overly excited about new drugs, ending with a sardonic hope for another new antidepressant, SAGE-217. Shorter summary