18
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Current pharmacotherapy approaches and novel GABAergic antidepressant development in postpartum depression

      review-article
      a , b , c , d , e
      Dialogues in Clinical Neuroscience
      Taylor & Francis
      Postpartum depression, allopregnanolone, neuroactive steroids, brexanolone, zuranolone, treatment

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Postpartum depression has deleterious effects on childbearing persons globally. Existing treatments have been largely extrapolated from those for other forms of depression and have included pharmacotherapy, psychotherapy, and neuromodulation. Hormonal treatments with oestrogen and progestogens, thought to be a rational approach to treatment in response to an emerging literature on the pathophysiology of postpartum depression, have only limited evidence for efficacy to date. Novel antidepressant development with allopregnanolone analogues, in contrast, has proven a promising avenue for the development of rationally designed and efficacious treatments. This state-of-the-art review presents the evidence for the current standard-of-care pharmacotherapy, hormonal treatment, and emerging allopregnanolone analogues for the treatment of postpartum depression along with a discussion of the current understanding of its neuroactive steroid-driven pathophysiology.

          Related collections

          Most cited references60

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes

          Introduction: The postpartum period represents the time of risk for the emergence of maternal postpartum depression. There are no systematic reviews of the overall maternal outcomes of maternal postpartum depression. The aim of this study was to evaluate both the infant and the maternal consequences of untreated maternal postpartum depression. Methods: We searched for studies published between 1 January 2005 and 17 August 2016, using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane Pregnancy and Childbirth Group trials registry. Results: A total of 122 studies (out of 3712 references retrieved from bibliographic databases) were included in this systematic review. The results of the studies were synthetized into three categories: (a) the maternal consequences of postpartum depression, including physical health, psychological health, relationship, and risky behaviors; (b) the infant consequences of postpartum depression, including anthropometry, physical health, sleep, and motor, cognitive, language, emotional, social, and behavioral development; and (c) mother–child interactions, including bonding, breastfeeding, and the maternal role. Discussion: The results suggest that postpartum depression creates an environment that is not conducive to the personal development of mothers or the optimal development of a child. It therefore seems important to detect and treat depression during the postnatal period as early as possible to avoid harmful consequences.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Effects of gonadal steroids in women with a history of postpartum depression.

            Endocrine factors are purported to play a role in the etiology of postpartum depression, but direct evidence for this role is lacking. The authors investigated the possible role of changes in gonadal steroid levels in postpartum depression by simulating two hormonal conditions related to pregnancy and parturition in euthymic women with and without a history of postpartum depression. The supraphysiologic gonadal steroid levels of pregnancy and withdrawal from these high levels to a hypogonadal state were simulated by inducing hypogonadism in euthymic women-eight with and eight without a history of postpartum depression-with the gonadotropin-releasing hormone agonist leuprolide acetate, adding back supraphysiologic doses of estradiol and progesterone for 8 weeks, and then withdrawing both steroids under double-blind conditions. Outcome measures were daily symptom self-ratings and standardized subjective and objective cross-sectional mood rating scales. Five of the eight women with a history of postpartum depression (62.5%) and none of the eight women in the comparison group developed significant mood symptoms during the withdrawal period. Analysis of variance with repeated measures of daily and cross-sectional ratings of mood showed significant phase-by-group effects. These effects reflected significant increases in depressive symptoms in women with a history of postpartum depression but not in the comparison group after hormone withdrawal (and during the end of the hormone replacement phase), compared with baseline. The data provide direct evidence in support of the involvement of the reproductive hormones estrogen and progesterone in the development of postpartum depression in a subgroup of women. Further, they suggest that women with a history of postpartum depression are differentially sensitive to mood-destabilizing effects of gonadal steroids.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Brexanolone injection in post-partum depression: two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials

              Post-partum depression is associated with substantial morbidity, and improved pharmacological treatment options are urgently needed. We assessed brexanolone injection (formerly SAGE-547 injection), a positive allosteric modulator of γ-aminobutyric-acid type A (GABAA) receptors, for the treatment of moderate to severe post-partum depression.
                Bookmark

                Author and article information

                Journal
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues in Clinical Neuroscience
                Taylor & Francis
                1294-8322
                1958-5969
                5 October 2023
                2023
                5 October 2023
                : 25
                : 1
                : 92-100
                Affiliations
                [a ]Department of Psychiatry, Maimonides Medical Center , Brooklyn, NY, USA
                [b ]Downstate Health Sciences University, The State University of New York , Brooklyn, NY, USA
                [c ]Departments of Obstetrics & Gynecology and of Psychiatry, Weill Cornell Medicine , New York, NY, USA
                [d ]The Feinstein Institutes for Medical Research, Northwell Health , Manhasset, NY, USA
                [e ]Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Hempstead, NY, USA
                Author notes

                Supplemental data for this article can be accessed online at https://doi.org/10.1080/19585969.2023.2262464.

                CONTACT Kristina M. Deligiannidis Kdeligian1@ 123456northwell.edu
                Author information
                https://orcid.org/0000-0002-9896-6094
                https://orcid.org/0000-0003-0979-7901
                https://orcid.org/0000-0001-7439-2236
                Article
                2262464
                10.1080/19585969.2023.2262464
                10557560
                37796239
                c4f6a754-6de8-44bd-b144-4b86464e436f
                © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

                History
                Page count
                Figures: 1, Tables: 0, Pages: 9, Words: 6052
                Categories
                Review Article
                Review

                Neurosciences
                postpartum depression,allopregnanolone,neuroactive steroids,brexanolone,zuranolone,treatment

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content247

                Cited by4

                Most referenced authors564