Pinna Graziano, Almeida Felipe B, Davis John M
The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.
Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.
Front Glob Womens Health. 2022 Apr 26;3:823616. doi: 10.3389/fgwh.2022.823616. eCollection 2022.
Postpartum depression (PPD) is a debilitating psychiatric disorder characterized by a high worldwide prevalence and serious long-term negative outcomes for both mothers and children. The lack of a specific treatment and overreliance on pharmacotherapy with limited efficacy and delayed treatment response has constituted a complication in the management of PPD. Recently, the Food and Drug Administration (FDA) in the USA approved a synthetic formulation of the GABAergic neurosteroid allopregnanolone, administered intravenously (brexanolone) for the rapid, long-lasting and effective treatment of PPD. Hereinafter, we review findings on allopregnanolone biosynthesis and GABA receptor plasticity in the pathophysiology of PPD. We also discuss evidence supporting the efficacy of brexanolone for the treatment of PPD, which opens a promising new horizon for neurosteroid-based therapeutics for mood disorders.
产后抑郁症(PPD)是一种使人衰弱的精神障碍,其特点是在全球范围内患病率很高,并且对母亲和儿童都会产生严重的长期负面后果。缺乏特异性治疗方法以及过度依赖疗效有限且治疗反应延迟的药物治疗,已成为产后抑郁症管理中的一个难题。最近,美国食品药品监督管理局(FDA)批准了一种γ-氨基丁酸(GABA)能神经甾体别孕烯醇酮的合成制剂,通过静脉注射给药(布雷沙诺龙),用于快速、持久且有效地治疗产后抑郁症。在此,我们综述了关于别孕烯醇酮生物合成以及产后抑郁症病理生理学中GABA受体可塑性的研究结果。我们还讨论了支持布雷沙诺龙治疗产后抑郁症疗效的证据,这为基于神经甾体的情绪障碍治疗开辟了一个充满希望的新前景。