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Brexanolone: Postpartum Depression Treatment Explained
Key Points About Brexanolone for Postpartum Depression Treatment
Brexanolone is a prescription medication specifically developed to treat postpartum depression (PPD) in adult women. It is administered through an intravenous (IV) infusion over a carefully monitored period and works by targeting specific brain chemicals involved in regulating mood. If you are considering this treatment, it is essential to consult a healthcare provider to determine whether Brexanolone is the right option for you. Our telemedicine providers are here to help guide you through your postpartum depression treatment options with care and expertise.
Medication Names: Brexanolone and Zulresso
US Brand Name: Zulresso
Generic Name: Brexanolone
The generic name, Brexanolone, refers to the active ingredient in the medication, while Zulresso is the brand name given by the manufacturer. Both terms are often used interchangeably when discussing this treatment for postpartum depression.
Pharmacologic Category of Brexanolone
Brexanolone belongs to the pharmacologic category of Neuroactive Steroid GABA-A Receptor Modulators. This classification highlights its mechanism of action, which involves modulating specific receptors in the brain to address mood disorders like postpartum depression.
Brexanolone Dosing for Postpartum Depression Treatment
Brexanolone is approved for the treatment of postpartum depression in adult women. Its dosing regimen is highly specific and must be administered under strict medical supervision to ensure both safety and effectiveness.
Dosing Schedule for Postpartum Depression
Initial Dose: The infusion begins at 30 mcg/kg/hour for the first 4 hours.
Next Dose: The dose is increased to 60 mcg/kg/hour for the following 20 hours.
Final Dose: The dose is reduced to 30 mcg/kg/hour for the next 4 hours, followed by a taper to 15 mcg/kg/hour during the final 4 hours of the 60-hour infusion.
The total treatment duration is 60 continuous hours, administered as an IV infusion in a certified healthcare facility. It is crucial to follow your doctor’s instructions and never attempt to adjust the dose on your own. If you have any questions or concerns about your Brexanolone infusion, our telemedicine providers are available to assist you.
Dosage Forms and Strengths of Brexanolone
Form: Intravenous (IV) solution
Strength: 100 mg/20 mL (5 mg/mL) in a single-dose vial
How to Administer Brexanolone
Brexanolone is administered as a continuous intravenous infusion over 60 hours in a certified healthcare facility. During the infusion, your healthcare provider will closely monitor you for any side effects or changes in your condition. It is essential to remain in the healthcare setting for the entire duration of the treatment. Be sure to inform your healthcare provider about any other medications you are taking or any medical conditions you have to ensure the safe and effective administration of this postpartum depression treatment.
Brexanolone Side Effects and Adverse Reactions
As with any medication, Brexanolone may cause side effects. While some are common and manageable, others are rare but potentially serious. Being informed about these side effects is important, and you should contact your healthcare provider if you experience any concerning symptoms during or after your Brexanolone infusion.
Common Side Effects of Brexanolone
- Dizziness: A sensation of lightheadedness or unsteadiness, particularly when standing up.
- Sleepiness (sedation): Unusual drowsiness or fatigue that may occur during or after the infusion.
- Dry mouth: A noticeable reduction in saliva, leading to a dry or uncomfortable feeling in the mouth.
Less Common but Serious Side Effects
- Loss of consciousness: Fainting or passing out during the infusion, which requires immediate medical attention.
- Severe allergic reactions: Symptoms may include rash, itching, swelling, or difficulty breathing. Seek emergency care if you experience any of these signs.
- Suicidal thoughts or behaviors: If you notice worsening depression or thoughts of self-harm, contact your healthcare provider immediately.
If you experience any side effects, whether mild or severe, notify your healthcare provider promptly. Our telemedicine providers are available to address any concerns you may have about your Brexanolone treatment and provide the support you need.
Contraindications for Brexanolone
A contraindication refers to a specific condition or circumstance in which a medication, such as Brexanolone, should not be used because it may pose significant risks. If you are considering Brexanolone for the treatment of postpartum depression, it is important to be aware of the following contraindications:
Severe kidney disease: Brexanolone is metabolized and excreted through the kidneys. In individuals with severe kidney disease, the medication may not be effectively cleared from the body, which could increase the risk of side effects or toxicity.
Allergic reaction to Brexanolone or its ingredients: If you have previously experienced an allergic reaction to Brexanolone (also known by its brand name, Zulresso) or any of its components, taking it again could result in serious allergic reactions, including anaphylaxis—a potentially life-threatening condition.
Unstable or poorly controlled depression: If your depression is not well-managed or you are experiencing suicidal thoughts, Brexanolone may not be an appropriate treatment option. It is essential to share your mental health history with your healthcare provider to determine whether this medication is safe and suitable for you.
Drug-to-Drug Interactions with Brexanolone
Brexanolone infusion therapy has the potential to interact with other medications, which may either amplify side effects or reduce the effectiveness of treatment. It is vital to inform your healthcare provider about all medications you are currently taking, including prescription drugs, over-the-counter medications, supplements, and herbal products. Key drug interactions include:
Central nervous system (CNS) depressants: Medications such as benzodiazepines (e.g., Xanax [alprazolam], Valium [diazepam]) or opioids (e.g., OxyContin [oxycodone], Vicodin [hydrocodone]) can intensify Brexanolone’s sedative effects. This combination may lead to excessive drowsiness or, in severe cases, respiratory depression.
Antidepressants: Certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine) or Zoloft (sertraline), may interact with Brexanolone. When these medications are used together, close monitoring for changes in mood or the emergence of side effects is recommended.
Antiepileptic drugs: Seizure medications, such as Tegretol (carbamazepine) or Depakote (valproate), may influence how Brexanolone is processed in the body, potentially altering its effectiveness. Your healthcare provider may need to adjust your treatment plan accordingly.
Brexanolone and Pregnancy
Is Brexanolone safe to use during pregnancy? The safety of Brexanolone for treating postpartum depression in pregnant individuals has not been fully established. Limited human data is available, and animal studies suggest there may be potential risks to the developing fetus. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of Brexanolone infusion therapy with your healthcare provider. They can help you make an informed decision about whether this treatment is appropriate for your situation.
Brexanolone While Breastfeeding
Can Brexanolone be used while breastfeeding? Brexanolone does pass into breast milk, but its effects on a nursing infant are not yet fully understood. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to carefully weigh the potential risks and benefits. They may recommend monitoring your baby for any unusual symptoms or suggest alternative treatments for postpartum depression if necessary.
Estimated Cost of Brexanolone Treatment
The cost of Brexanolone treatment can be significant. Without insurance, the price for a full treatment course—administered as a continuous intravenous (IV) infusion over 60 hours—typically ranges from $20,000 to $34,000, even when using a GoodRX coupon. This high cost is largely due to the specialized delivery method. If you are considering Brexanolone for postpartum depression, speak with your healthcare provider or pharmacist about financial assistance programs or other resources that may help make this treatment more affordable.
Possible Alternatives for Postpartum Depression Treatment
For postpartum depression, several alternative treatments and lifestyle adjustments may help ease symptoms. It’s essential to consult your healthcare provider before making any changes to your treatment plan. Some effective options include:
Antidepressant medications: Selective serotonin reuptake inhibitors (SSRIs), such as Zoloft (sertraline) or Prozac (fluoxetine), are frequently prescribed for postpartum depression. These medications are generally considered safe for breastfeeding mothers and can help regulate mood by balancing serotonin levels in the brain.
Cognitive-behavioral therapy (CBT): This evidence-based form of talk therapy focuses on identifying and reshaping negative thought patterns. By addressing these patterns, CBT can improve mood, enhance coping skills, and support overall mental well-being.
Exercise: Engaging in regular physical activity has been shown to boost mood and alleviate symptoms of depression. Even light activities, such as walking, stretching, or practicing yoga, can provide meaningful benefits by releasing endorphins and reducing stress.
Support groups: Connecting with others who are experiencing postpartum depression or joining a group for new mothers can offer valuable emotional support. Sharing experiences in a supportive environment can help reduce feelings of isolation and foster a sense of community.
Recent Updates on Brexanolone Research
Recent studies on Brexanolone have explored its long-term effectiveness and safety in treating postpartum depression. A 2021 study found that patients who received a Brexanolone infusion experienced significant symptom relief, with some maintaining these improvements for up to 30 days after treatment. Researchers are also investigating whether Brexanolone could be effective for other types of depression, such as major depressive disorder (MDD). However, more research is needed before it can be approved for broader applications.
As research continues to evolve, staying informed about new developments is essential. If you have questions about Brexanolone for postpartum depression or other treatment options, consider scheduling a telemedicine appointment with one of our providers. They can help you navigate the latest findings and work with you to determine the most appropriate treatment plan for your needs.
