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Brexanolone, a GABAA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review
Frontiers in Psychiatry
  • Amber N Edinoff, Louisiana State University Health Science Center
  • Amira S. Odisho, Louisiana State University
  • Kendall Lewis, Louisiana State University
  • Amir Kaskas, Louisiana State University
  • Grace Hunt, Louisiana State University
  • Elyse M Cornett, Louisiana State University
  • Alan David Kaye, Louisiana State University Health Science Center
  • Adam M. Kaye, University of the Pacific
  • John Morgan, Louisiana State University
  • P. Scott Barrilleaux, Louisiana State University
  • David Lewis, Louisiana State University in Shreveport
  • Omar Viswanath, University of Arizona
  • Ivan Urits, Louisiana State University
ORCiD
Adam M. Kaye: 0000-0002-7224-3322
Document Type
Article
DOI
10.3389/fpsyt.2021.699740
Publication Date
9-14-2021
Abstract

Postpartum depression (PPD) is one of the three major categories on the spectrum of postpartum psychiatric syndromes. Postpartum psychiatric syndromes are classified as either postpartum blues, postpartum depression, or postpartum psychosis. Postpartum depression is important to recognize clinically because of the effect it can have on the mother-child bond. The neurosteroid allopregnanolone, a progesterone derivative, is important for its role in positively modulating GABAA receptors. GABA-mediated signaling has been previously implicated in major depressive disorder. Allopregnanolone-mediated signaling has been identified as an important therapeutic target. Treatment with an allopregnanolone-analog, brexanolone, has been shown to improve depression scores in trials for the treatment of PPD. Brexanolone is a positive allosteric modulator of GABAA and is the first drug approved by the FDA to treat postpartum depression. Brexanolone enhances the inhibitory effects of GABAA, restores dysfunctional GABAA transmembrane channels, and mimics a naturally produced progesterone metabolite that fluctuates during pregnancy and postpartum. One open-label study and two phase two studies have some significant reduction in HAM-D scores after treatment and that the effect was still there 30 days post-treatment. Per the data reported, intravenous infusion of brexanolone could be efficacious and safe for the treatment of women suffering from postpartum depression.

Creative Commons License
Creative Commons Attribution 4.0 International
Citation Information
Amber N Edinoff, Amira S. Odisho, Kendall Lewis, Amir Kaskas, et al.. "Brexanolone, a GABAA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review" Frontiers in Psychiatry Vol. 12 (2021) ISSN: 1664-0640
Available at: http://works.bepress.com/adam-kaye/172/