The monoaminergic drugs are standard-of-care antidepressants; however, the vast majority of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) do not address critical unmet needs in the depression market. Additionally, these classes are saturated with generics, significantly dampening their commercial potential. More recent market entrants such as Spravato and Auvelity are highly attractive in their capacity to fulfill unmet needs through their approvals for difficult-to-treat patient populations coupled with their refreshing first-in-class mechanisms. While these drugs are not, and may never be, first-line standard-of-care antidepressants, they boast impressive commercial and clinical potential and deliver much-needed novelty to major depressive disorder's (MDD’s) relatively homogenous pharmaceutical landscape. 

Zurzuvae has joined Sage’s other asset, Zulresso, as the only two approved treatments in the US indicated specifically for postpartum depression (PPD). As the sole company providing PPD-indicated drugs, this represents a significant market opportunity for Sage, even without the MDD population the company had originally hoped to garner. The more convenient oral formulation of Zurzuvae will likely overshadow the already slow uptake of intravenous Zulresso.