Background: Major depressive disorder (MDD) and postpartum depression (PPD) are disabling conditions. This integrated analysis of MDD and PPD clinical trials investigated the impact of zuranolone-a positive allosteric modulator of synaptic and extrasynaptic GABA A receptors and neuroactive steroid under investigation for adults with MDD and approved as an oral, once-daily, 14-day treatment course for adults with PPD in the US-on health-related quality of life, including functioning and well-being, as assessed using the 36-item Short Form Health Survey V2 (SF-36)., Methods: Integrated data from 3 MDD (201B, MOUNTAIN, WATERFALL) and 1 PPD trial (ROBIN) for individual SF-36 domains were compared for zuranolone (30- and 50-mg) vs placebo at Day (D)15 and D42. Comparisons between zuranolone responders (≥50 % reduction from baseline in 17-item Hamilton Depression Rating Scale total score) and nonresponders were assessed., Results: Overall, 1003 patients were included (zuranolone, n = 504; placebo, n = 499). Significant differences in change from baseline (CFB) to D15 for patients in zuranolone vs placebo groups were observed in 6/8 domains; changes were sustained or improved at D42, with significant CFB differences for all 8 domains. Zuranolone responders had significantly higher CFB scores vs nonresponders for all domains at D15 and D42 (p < 0.001)., Limitations: Two zuranolone doses were integrated across populations of 2 disease states with potential differences in functioning, comorbidities, and patient demographics. All p-values presented are nominal., Conclusions: Integrated data across 4 zuranolone clinical trials showed improvements in functioning and well-being across all SF-36 domains. Benefits persisted after completion of treatment course at D42., Competing Interests: Declaration of competing interest Dr. Clayton has received grant support from Daré Bioscience, Janssen, Otsuka, Praxis Precision Medicines, Relmada Therapeutics, and Sage Therapeutics, Inc.; advisory board or consulting fees from AbbVie; Brii Biosciences; Fabre-Kramer; Initiator Pharma; Janssen Research and Development; Mycomedica Life Sciences; Praxis Precision Medicines; PureTech Health; Reunion Neuroscience (formerly Field Trip Health); S1 Biopharma; Sage Therapeutics, Inc.; Sertsei Pharmaceuticals, Inc.; and Vella Bioscience; and royalties from Ballantine Books/Random House, the Changes in Sexual Functioning Questionnaire, and Guilford Publications. She also holds shares/restricted stocks in Euthymics, Mediflix, and S1 Biopharma. Dr. Suthoff is an employee of Sage Therapeutics, Inc., and may hold stock and/or stock options. Drs. Huang and Bonthapally are former employees of Sage Therapeutics, Inc., and may hold stock and/or stock options. Dr. Jain received an honorarium from Amgen and consultant fees from Chugai, Merck, Ophthotech, Pfizer, SPARC, and SynDevRx; owns equity in Accurius, Enlight, Ophthotech, and SynDevRx; and serves on the Boards of Trustees of Tekla Healthcare Investors, Tekla Healthcare Opportunities Fund, Tekla Life Sciences Investors, and Tekla World Healthcare Fund. Dr. Kosinki works for QualityMetric, the publisher of the SF-36v2. Dr. Fridman has received consulting fees from Arena; CSL Behring; Gilead Sciences, Inc.; GlaxoSmithKline; Janssen; Jazz; Kala; KalVista; Novo Nordisk; Pfizer; Reata; and Sage Therapeutics, Inc.; and grants from the California State Department of Public Health, National Institutes of Health (NIH), and Patient-Centered Outcomes Research Institute (PCORI). Dr. Deligiannidis serves as a consultant to Brii Biosciences, Inc.; Gerbera Therapeutics; GH Research Ltd.; Neuroscience Software, Inc.; Reunion Neuroscience; and Sage Therapeutics, Inc.; reports grants from Sage Therapeutics, Inc., awarded to Zucker Hillside Hospital/Feinstein Institutes for Medical Research during the conduct of the brexanolone injection and zuranolone clinical trials; and received grants from the NIH, Premier Healthcare, and Woebot Health and royalties from an NIH employee invention outside of the submitted work. Dr. Meltzer-Brody reports grants and other research funding from Sage Therapeutics, Inc., awarded to the University of North Carolina at Chapel Hill during the conduct of the study; grant funding from Janssen awarded to the University of North Carolina Chapel Hill; and grants from the NIH and PCORI. She also reports advisory board or consulting fees from Embarck Neuro, Modern Health, and WebMD/MedScape outside the submitted work. Dr. Chen and Dr. Gervitz are employees of Biogen Inc. and may hold stock. Dr. Trivedi has served as a consultant or advisor for Alto Neuroscience Inc., Axsome Therapeutics, Biogen Inc., Cerebral Inc., Circular Genomics Inc., Compass Pathfinder Limited, Daiichi Sankyo Inc., GH Research, Heading Health, Janssen, Legion Health, Merck Sharp & Dohme, Mind Medicine Inc., Naki Health Ltd., Neurocrine Biosciences Inc., Otsuka America Pharmaceutical Inc., Otsuka Pharmaceutical Development & Commercialization Inc., Praxis Precision Medicines Inc., Relmada Therapeutics Inc., Sage Therapeutics, Inc., Signant Health, Sparian Biosciences, Takeda Pharmaceuticals Inc., and WebMD. He has received grant/research funding from American Foundation for Suicide Prevention, Blue Cross Blue Shield of Texas, NCATS, NIDA, NIMH, and PCORI. Additionally, he has received editorial compensation from Engage Health Media and Oxford University Press., (Copyright © 2024. Published by Elsevier B.V.)