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Review
. 2022 Apr 26:3:823616.
doi: 10.3389/fgwh.2022.823616. eCollection 2022.

Allopregnanolone in Postpartum Depression

Graziano Pinna  1 , Felipe B Almeida  1   2 , John M Davis  1
Affiliations
Review

Allopregnanolone in Postpartum Depression

Graziano Pinna et al. Front Glob Womens Health. .

Abstract

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 GABAA 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.

Keywords: GABAA receptors; allopregnanolone; brexanolone; neurosteroid-based therapeutics; post-partum depression; rapid-acting antidepressants.

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Conflict of interest statement

GP is a paid consultant to PureTech Health (Boston, MA, USA), GABA Therapeutics, and NeuroTrauma Sciences (Alpharetta, GA, USA). He has two patent applications, one on N-palmitoylethanolamine (PEA) and peroxisome proliferator-activated receptor alpha (PPAR-α) agonists US20180369171A1, pending, and one on allopregnanolone analogs US11266663B2 granted on March 8, 2022 in the treatment of neuropsychiatric disorders. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Representation of frequent risk factors and outcomes of major depressive disorder and postpartum depression (PPD).
See this image and copyright information in PMC

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