Brexanolone, zuranolone and related neurosteroid GABA <sub>A</sub> receptor positive allosteric modulators for postnatal depression
Claire A. Wilson, Lindsay Robertson, Karyn Ayre, Jessica Hendon, Sarah Dawson, Charlene Bridges, Hind Khalifeh
Abstract
BACKGROUND: ) receptor positive allosteric modulators have been developed for the treatment of depression, including postnatal depression, and have a different mechanism of action than traditional antidepressants. OBJECTIVES: receptor positive allosteric modulators compared to another active treatment (pharmacological, psychological or psychosocial), placebo or treatment as usual for postnatal depression. SEARCH METHODS: We searched Cochrane Common Mental Disorders' Specialised Register, CENTRAL, MEDLINE, Embase and PsycINFO in January 2024. We also searched two international trials registries and contacted experts in the field to identify the studies that are included in the review. SELECTION CRITERIA: receptor positive allosteric modulators with any other treatment (pharmacological, psychological or psychosocial), placebo or treatment as usual. DATA COLLECTION AND ANALYSIS: receptor positive allosteric modulator was intravenous or oral. We assessed the certainty of the evidence using GRADE criteria. MAIN RESULTS: = 5%; 2 studies, 349 women). No studies measured quality of life. One study reported the Barkin Index of Maternal Functioning (a validated measure of patient-reported maternal functioning within the first year of childbirth), and found that zuranolone improved maternal functioning at day 45 (MD 7.20, 95% CI 1.42 to 12.98; 153 women), but the certainty of this evidence was low. AUTHORS' CONCLUSIONS: receptor positive allosteric modulators for the treatment of postnatal depression as no studies have compared them to active treatment.