Brexanolone For Postpartum Depression: A Novel Approach and a Call for Comprehensive Postpartum Care

• Published in: Clinical therapeutics Vol. 42; no. 1; pp. 231 - 235
• Main Authors: Jarman, Angela F., MacLean, Joanna V., Barron, Rebecca J., Wightman, Rachel S., McGregor, Alyson J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2020; Elsevier Limited
• Subjects: Antidepressants; Babies; Breastfeeding & lactation; Brexanolone; Child development; Childbirth & labor; Clinical trials; Family physicians; FDA approval; Hormones; Intravenous administration; Intravenous infusion; Maternity & paternity leaves; Mental depression; Mood; Mothers; Pharmacotherapy; Physicians; Postpartum; Postpartum depression; Postpartum period; Pregnancy; Pregnanolone; Progesterone; Social determinants; Womens health; United States > US; Pharmacotherapy; Postpartum depression; Social determinants; Brexanolone
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/j.clinthera.2019.11.005

Brexanolone recently became the first medication to be approved by the US Food and Drug Administration specifically for treating postpartum depression. In contrast to traditional antidepressants, however, brexanolone is a neurosteroid that is believed to mimic allopregnanolone, a product of endogenous progesterone. Although early clinical trials have shown success, the medication remains largely unavailable due to its extremely high cost and formulation (it must be given as a continuous intravenous infusion over 3 days in a monitored, inpatient setting). The efficacy data surrounding brexanolone are encouraging; there is also evidence, however, that postpartum depression may be mitigated by a number of social policies that provide support to new parents. We suggest a comprehensive approach to postpartum wellness that includes investing in evidence-based social interventions that may be much more accessible to the millions of Americans experiencing postpartum mood disturbance.