II. Indications
-
Postpartum Depression
- Major Depression starting in third trimester or first month postpartum
- Medication started within 12 months of delivery
III. Mechanism
- Similar to IV Brexanolone
- Mimics Allopregnanolone (GABA Receptor agent), known to decrease in peripartum period
IV. Precautions
V. Dosing
- Standard Adult Dosing
- Take 50 mg orally with a fatty meal in the evening for 14 days
- Indications to decrease dose to 30 mg daily
- Severe hepatic Impairment (Child-Pugh C)
- Moderate or severe renal Impairment (eGFR <60 ml/min)
- Strong CYP3A4 Inducer use
VI. Adverse Effects
- Costs $14,000 per 14 day course in 2024
- Drowsiness and confusion
- Avoid driving for 12 hours after each dose
- Avoid with other CNS Depressants (e.g. Opioids, Alcohol)
VII. Safety
- Avoid in pregnancy (may be Teratogenic)
- Use Contraception during treatment and for at least one week after completing medication
- Unknown safety in Lactation
- May cause sedation in the nursing infant
VIII. Drug Interactions
IX. Resources
X. References
- (2024) Presc Lett 31(2): 10-11