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Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?

Postpartum depression is considered to be a subtype of major depressive disorder that occurs in approximately 10–20% of mothers worldwide. However, in actuality, these numbers are likely underreported due to minimization and the stigma of mental illness. Until recently, there were no approved medica...

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Detalles Bibliográficos
Autores principales: Faden, Justin, Citrome, Leslie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656877/
https://www.ncbi.nlm.nih.gov/pubmed/33224470
http://dx.doi.org/10.1177/2045125320968658
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author Faden, Justin
Citrome, Leslie
author_facet Faden, Justin
Citrome, Leslie
author_sort Faden, Justin
collection PubMed
description Postpartum depression is considered to be a subtype of major depressive disorder that occurs in approximately 10–20% of mothers worldwide. However, in actuality, these numbers are likely underreported due to minimization and the stigma of mental illness. Until recently, there were no approved medications for the treatment of postpartum depression. Allopregnanolone is a naturally occurring neuroactive steroid whose serum levels decline precipitously following childbirth. This hormonal fluctuation has been postulated as playing a role in the pathophysiology of postpartum depression. Brexanolone is the first medication approved by the US Food and Drug Administration for the treatment of postpartum depression. Brexanolone is an intravenous proprietary formulation of allopregnanolone that can be administered to produce stable serum levels comparable with third-trimester concentrations in postpartum mothers. It is hypothesized to modulate neuronal excitability by functioning as an allosteric modulator of γ-aminobutyric acid-A receptors and is administered under monitoring as a 60 h continuous infusion. In this review, we will highlight the results of the clinical trial program, including efficacy and tolerability data. Practical and logistical considerations of brexanolone will be reviewed, as will its potential place in therapy for the treatment of postpartum depression.
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spelling pubmed-76568772020-11-20 Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used? Faden, Justin Citrome, Leslie Ther Adv Psychopharmacol Review Postpartum depression is considered to be a subtype of major depressive disorder that occurs in approximately 10–20% of mothers worldwide. However, in actuality, these numbers are likely underreported due to minimization and the stigma of mental illness. Until recently, there were no approved medications for the treatment of postpartum depression. Allopregnanolone is a naturally occurring neuroactive steroid whose serum levels decline precipitously following childbirth. This hormonal fluctuation has been postulated as playing a role in the pathophysiology of postpartum depression. Brexanolone is the first medication approved by the US Food and Drug Administration for the treatment of postpartum depression. Brexanolone is an intravenous proprietary formulation of allopregnanolone that can be administered to produce stable serum levels comparable with third-trimester concentrations in postpartum mothers. It is hypothesized to modulate neuronal excitability by functioning as an allosteric modulator of γ-aminobutyric acid-A receptors and is administered under monitoring as a 60 h continuous infusion. In this review, we will highlight the results of the clinical trial program, including efficacy and tolerability data. Practical and logistical considerations of brexanolone will be reviewed, as will its potential place in therapy for the treatment of postpartum depression. SAGE Publications 2020-11-09 /pmc/articles/PMC7656877/ /pubmed/33224470 http://dx.doi.org/10.1177/2045125320968658 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Faden, Justin
Citrome, Leslie
Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
title Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
title_full Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
title_fullStr Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
title_full_unstemmed Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
title_short Intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
title_sort intravenous brexanolone for postpartum depression: what it is, how well does it work, and will it be used?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656877/
https://www.ncbi.nlm.nih.gov/pubmed/33224470
http://dx.doi.org/10.1177/2045125320968658
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