Northwell Health - Feinstein Institute for Medical Research

A breakthrough in the management of postpartum depression Even though physicians suspect postpartum depression may be caused by fluctuations in estrogen and progesterone, the most common medication used for the condition treats depression, which is biologically different. Developing a therapy specifically for postpartum depression may enhance treatment results. That's the goal of researchers from Feinstein Institute and study sponsor Sage Therapeutics Inc., who recently examined the efficacy of using brexanolone iv (USAN; formerly SAGE-547 injection) in treating severe postpartum depression. Women's bodies naturally create allopregnanolone, a metabolite of the hormone progesterone that has a calming effect. Previous research found a potential link between low levels of allopregnanolone during the second trimester of pregnancy and postpartum depression in at-risk women. Hastening the path to symptom reduction In the current study, published in The Lancet, the research team administered a 60-hour IV infusion of brexanolone to 10 women with postpartum depression who scored 26 or above on the Hamilton Rating Scale for Depression (HRSD), which defined severe disease in this study. Eleven women with similar HRSD scores received a placebo infusion. Researchers monitored the two groups for 30 days. At the end of that period, they observed an average 21-point reduction in depressive symptoms in the women who received brexanolone, compared to an eight-point reduction in the placebo group. "How much the depression resolved and how quickly it resolved were the standout results in this study," said Kristina Deligiannidis, MD, co-author of The Lancet study, associate professor in the Center for Psychiatric Neuroscience at the Feinstein Institute and director of women's behavioral health at The Zucker Hillside Hospital. "Currently, FDA-approved antidepressants can take weeks to fully resolve postpartum depression." As a continuation of this study, Sage Therapeutics is conducting larger phase 3 clinical trials of brexanolone in women with moderate and severe postpartum depression at several major US academic medical centers, including Northwell Health's Zucker Hillside Hospital. Positive initial results from the phase 3 trial were recently announced. "This investigational medicine may target the specific underlying causes of postpartum depression," Dr. Deligiannidis said. "If we replicate the findings that we observed in the small sample size of 21 women during the phase 3 trial, we'll have a new way of thinking about and treating the larger population of women who experience postpartum depression." Did you know? Fifteen out of 100 women in the United States will get depressed in the first three months after giving birth. About half of these women (eight out of 100) will have mild to moderate depression, and around seven out of 100 will suffer from severe depression. Medication personalized to the underlying cause of the condition could revolutionize treatment. FeinsteinInstitute.org 7 Patient success

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