[Neurosteroids as treatment of postpartum depression: a critical literature review].

Abstract

Background: Brexanolone (Zulresso) and zuranolone (Zurzuvae) are two synthetic neuroactive steroids that were approved by the U.S. Food and Drug Administration in March 2019 (as an intravenous treatment) and August 2023 (as an oral treatment) respectively, for the treatment of postpartum depression. To date, these products are not available in Belgium and The Netherlands.

Aim: To evaluate the effectiveness and side effects of brexanolone and zuranolone in the treatment of postpartum depression through the evaluation of previous double-blind placebo-controlled trials.

Method: A clinically oriented literature study.

Results: Brexanolone and zuranolone are effective in the treatment of postpartum depression with a clinically significant rapid response compared to placebo. The main reported side effects are dizziness, somnolence, and sedation.

Conclusion: Placebo-controlled studies support the effectiveness of treatment with brexanolone and zuranolone in postpartum depression, showing a rapid and statistically significant improvement in mood symptoms. However, the place of neurosteroids in practice is still unclear and needs to be clarified by future research and clinical experience.