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. 

Launched in December 2023, Zurzuvae (zuranolone) joined Sage’s first asset, Zulresso (brexanolone), as the only two treatments in the US ever approved specifically for PPD. However, the more convenient oral formulation of Zurzuvae combined with the already slow uptake of intravenous Zulresso led Sage to discontinue the latter in January 2025.