Associate Professor of Psychiatry and Behavioral Sciences, Women's Mood Disorders Center, Johns Hopkins School of Medicine, Baltimore, United States.
Expert Opin Pharmacother. 2021 Jun;22(8):959-964. doi: 10.1080/14656566.2021.1897105. Epub 2021 Mar 12.
Postpartum depression (PPD) is a serious and common complication of childbirth that can have deleterious effects not only on the mother but on the cognitive and behavioral development of exposed children. Brexanolone is a novel, soluble synthetic formulation of the natural hormone allopregnanolone and acts as a positive allosteric modulator of the gamma-aminobutyric acid A receptor (GABAA). Allopregnanolone levels dramatically decrease during the postpartum time-period and some studies indicate lower serum levels of allopregnanolone during pregnancy in women that go on to develop PPD.Areas covered: The author provides an overview of brexanolone as a treatment option for PPD including coverage of its pharmacokinetics, efficacy, safety, and tolerability. Furthermore, the author gives her expert perspectives on its use and its standing in the treatment armamentarium moving forward.Expert opinion: Brexanolone represents a breakthrough for psychiatry due to its novel mechanism of action, its rapid onset of action, and its sustained effects without continued administration. It is appropriate for use in women with moderate to severe PPD. Experience with the medication and further research is needed to clarify whether the current recommended dosing regimen is required for efficacy.
产后抑郁症（PPD）是一种严重且常见的分娩并发症，不仅会对母亲产生有害影响，还会对暴露于其中的儿童的认知和行为发育产生影响。Brexanolone 是一种新型的、可溶性的天然激素孕烷醇酮的合成制剂，作为γ-氨基丁酸 A 受体（GABAA）的正变构调节剂。孕烷醇酮水平在产后期间急剧下降，一些研究表明，在发展为 PPD 的女性中，怀孕期间的血清孕烷醇酮水平较低。
作者提供了 Brexanolone 作为 PPD 治疗选择的概述，包括其药代动力学、疗效、安全性和耐受性。此外，作者还从专家的角度出发，对其使用及其在未来治疗手段中的地位进行了探讨。
Brexanolone 因其新颖的作用机制、快速的作用起效和持续的效果而无需持续给药，代表了精神病学的突破。它适用于患有中重度 PPD 的女性。需要进一步的研究来明确目前推荐的剂量方案是否有效。
