In plain words
Brexanolone is a medicine the US Food and Drug Administration approved in 2019 for in adults. It is given through an IV in a healthcare setting. The person is watched closely for heavy sleepiness. It works in a way similar to , a hormone that drops sharply after birth. Trials reported better depression scores within days for many people. It is one option for severe postpartum depression. Psychotherapy and other medicines are also used. A psychiatrist decides whether it fits a particular person. It has its own safety warnings, including heavy sedation.
The deeper version
Brexanolone is a synthetic neuroactive steroid and positive allosteric modulator of receptors, an analogue of allopregnanolone. The US FDA approved it in March 2019 for postpartum depression in adults. The approval rested on phase 2 and phase 3 trials (Kanes and colleagues, Lancet, 2017; Meltzer-Brody and colleagues, Lancet, 2018) that showed reductions in Hamilton Depression Rating Scale scores within days compared with placebo. The label carries a boxed warning for excessive sedation and loss of consciousness, and administration requires monitoring in a certified setting. , approved in 2023, is a related agent. Limitations include infusion-based administration, short trial durations, and uncertainty about how long benefit lasts. How neurosteroid signaling relates to remains an open research question.
Where it comes up
- Postpartum depressionPostpartum: Mind
- Therapy and medication after birth: what the options arePostpartum: Mind
- Postpartum anxietyPostpartum: Mind
- When to get help, and who to call tonightPostpartum: Mind
- Depression during pregnancyPregnancy: Mind and Life
What mothers here say about brexanolone
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Sources
- US Food and Drug Administration — Zulresso (brexanolone) prescribing information, approved 2019
- Kanes S and colleagues — Brexanolone (SAGE-547 injection) in post-partum depression: a randomised controlled trial. The Lancet, 2017