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Clin Ther. 2020 Jan 3. pii: S0149-2918(19)30566-1. doi: 10.1016/j.clinthera.2019.11.005. [Epub ahead of print]

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

Author information

1
Department of Emergency Medicine, University of California Davis, Sacramento, CA, USA. Electronic address: angela.jarman@gmail.com.
2
Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
3
Department of Emergency Medicine, Portsmouth Regional Hospital, Portsmouth, NH, USA.
4
Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI, USA; Division of Medical Toxicology, Alpert Medical School, Brown University, Providence, RI, USA.
5
Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI, USA.

Abstract

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.

KEYWORDS:

Brexanolone; Pharmacotherapy; Postpartum depression; Social determinants

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