Скачать или смотреть Brexanolone for Postpartum Depression

Background
Brexanolone (BRX) has demonstrated short-term efficacy for the treatment of postpartum depression (PPD). Postpartum depression is linked to infanticide and maternal suicide, and current treatment often fails to adequately control depressive symptoms. Brexanolone is an aqueous form of the steroid allopregnanolone and is thought to improve depressive symptoms after childbirth by modulating neuronal excitability through positive allosteric modulation of the GABA type-A receptor. As 40% of women experience their first episode of depression during the postpartum period, and untreated PPD increases the risk of depression 6-fold later in life, investigating the utilization of BRX is warranted.

Purpose
The purpose of the proposed research is to further understand the experience of women who have received brexanolone for the treatment of PPD and to determine its effectiveness beyond 30 days.

Methods
This project was funded by the College of Psychiatric and Neurologic Pharmacists Foundation Defining the Future Research Grant. In this study, we will conduct semi-structured interviews modeled after the Theory of Planned Behavior (TPB) to assess women’s perceptions of treatment for PPD with brexanolone. The TPB assesses behavioral beliefs, perceived behavioral control, and subjective norms, and is often used to predict intention to perform health-related behaviors. Semi-structured interviews will be recorded and transcribed in order to conduct thematic analysis using NVIVO software. Further, we will conduct a retrospective chart review to assess for a change in depressive symptoms based on ratings documented in the electronic health record. Demographic data will also be collected, including obstetric history, time until BRX administration after birth, ethnicity, race, history of psychiatric illness, whether or not concurrent treatment with an antidepressant was received, and family history of PPD. Approximately ten patients will be included in this review.

Outcomes
Through semi-structured interviews, we hope to generate rich qualitative data that informs the design of a quantitative instrument to further assess intention to utilize brexanolone for the treatment of PPD. The primary outcome measure for our retrospective review will be a change in the Edinburgh Postnatal Depression Scale (EDPS) before, during, and after infusion with brexanolone.