Postpartum depression gets a pill

For the first time, there’s an FDA-approved pill to treat post-partum depression. Sure, antidepressants are a dime a dozen, but what makes zuranolone notable is that it works quickly and only needs to be taken for two weeks. (In fact, testing zuranolone as a treatment for major depressive disorder found that the effect wears off.)

Like the IV drug brexanolone, zuranolone helps regulate the GABA-A receptor, but it’s a simple pill without brexanolone’s side effects or need for a 3-day infusion.

(Why yes, someone did call it a “game-changer.”)

Steroids for infants: a “doubled-edged sword”

When mom-to-be is at risk of a preterm birth, steroids are the answer. The trouble is, we might not be asking all the right questions.

Sure, McMaster University researchers found, 40% of those babies go full term. But the downside is that they might have have a bunch of other issues “including neonatal intensive care admission, respiratory and growth issues, and adverse neurodevelopmental outcome.”

In other words, better assessments need to be done before considering steroids.

For infants born very prematurely, antenatal steroids potentially save lives and reduce severe morbidity but as pregnancy progresses to term, the benefits shift to risks.

RSV shot approved

The CDC is now recommending the RSV vaccine — nirsevimab, Beyfortus to its friends — “for all infants under 8 months and some older babies at increased risk of severe illness caused by respiratory syncytial virus (RSV).” This comes just days after its Advisory Committee on Immunization Practices voted unanimously for that recommendation.

“RSV,” the CDC reminds parents, “is the leading cause of hospitalizations for infants and older babies at higher risk.”

Vapes are sending kids to hospital

Not just from smoking — from cracking open the containers and drinking the liquid nicotine inside.

Cases of vaping-related nicotine exposure reported to poison centers hit an all-time high in 2022 — despite a 2016 law, the Child Nicotine Poisoning Prevention Act, that requires child-resistant packaging on bottles of vaping liquid. In what doctors call a major oversight, the law doesn’t require protective packaging on devices themselves.

So kids are prying open the cartridges and drinking the nicotine, which may be candy- or fruit-flavored. Oh, and besides nicotine there’s arsenic, lead, acetaldehyde, formaldehyde, and benzene in it. And they’re drinking it.

Fun fact: “Nearly 90% of exposures involved children under 5.”

Good (?) news:

“Fortunately, when kids do ingest these e-cig nicotine products, they self-decontaminate. They vomit — a lot — and this keeps the mortality rate very low, but these kids still often end up in emergency departments.

What comes around…

Sometimes bad choices take a while to come home to roost. Take anti-vaxxers, who first appeared en masse back in the late ’90s. Well now those unvaccinated kids are in their 20s, and guess what? “[T]he reality of measles as a disease that strikes almost uniquely in childhood is changing.”

There is […] a growing body of adults in this country who have no immunity against measles, experts say. In fact, since the year 2000, about 40% of measles cases in the U.S. have been in adults, with about one-quarter in people aged 20 to 29.

Uninsured rate: one step forward, but headwinds await

The good news: The number of Americans without health insurance hit its lowest level ever earlier this year.

The bad news: This was before states started removing people from the Medicaid rolls. “Medicaid disenrollments that accompanied the end of the Covid-19 public health emergency could quickly throw that trend in reverse.”

The Long Read: Atomic Engineering edition

Chemists are going beyond manipulating molecules to a level almost unthinkable a few years ago: not only manipulating individual atoms, but doing so at scale. Called skeletal editing, it’s to chemistry what CRISPR is to biology — with drugs instead of genes.

Skeletal editing could help to speed up drug discovery dramatically, and chemists […] have now developed reactions that can insert single nitrogen and oxygen atoms into the central rings of some molecules, sidestepping the need to start from scratch. “It will increase the speed at which we can make things, and it will increase the diversity of products we can make.”