Wei Zheng3, Dong-Bin Cai2, Wei Zheng3, Kang Sim4, Gabor S Ungvari5, Xiao-Jiang Peng6, Yu-Ping Ning1, Gang Wang7, Yu-Tao Xiang8. 1. The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China. 2. Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. 3. School of Medicine, Xiamen University, Xiamen, China. 4. Institute of Mental Health, Buangkok Green Medical Park, Singapore. 5. The University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia. 6. Guangzhou Civil Aviation College, Guangzhou, China. 7. The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. Electronic address: gangwangdoc@gmail.com. 8. Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida da Universidade, 3/F, Building E12, Taipa, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.
Abstract
OBJECTIVES: To systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD). METHODS: Randomized controlled trials (RCTs) were included. RESULTS: Two articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95%CI 1.03-1.73), peaked at 36 h (RR = 1.50, 95%CI 1.06-2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95%CI 1.01-1.73). Similarly, PPD women treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95%CI 1.03-3.34), peaking at 60 h (RR = 2.20, 95%CI 1.31-3.70) and lasting until 72 h (RR = 1.96, 95%CI 1.41-2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95%CI 1.35-5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo. CONCLUSION: A single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.
OBJECTIVES: To systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD). METHODS: Randomized controlled trials (RCTs) were included. RESULTS: Two articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95%CI 1.03-1.73), peaked at 36 h (RR = 1.50, 95%CI 1.06-2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95%CI 1.01-1.73). Similarly, PPDwomen treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95%CI 1.03-3.34), peaking at 60 h (RR = 2.20, 95%CI 1.31-3.70) and lasting until 72 h (RR = 1.96, 95%CI 1.41-2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95%CI 1.35-5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo. CONCLUSION: A single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.
Authors: Ashley A Conley; Amber E Q Norwood; Thomas C Hatvany; James D Griffith; Kathryn E Barber Journal: Psychopharmacology (Berl) Date: 2021-03-31 Impact factor: 4.530
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