Along with the joy of having a baby, some mothers can feel a lot of sadness, stress, loneliness, and fear. Everything is overwhelming, and sometimes they can't even think about their baby. We call this condition 'Postpartum Depression' or Postpartum Depression (PPD). This is not normal, and it requires medical advice. Today we are talking about a new, special treatment that can help with this.
What is Brexanolone?
Brexanolone is a medication used to treat postpartum depression (PPD). It is also commonly known by the brand name Zulresso.
Simply put, this medication works by balancing certain chemicals (neurotransmitters) in your brain. With the hormonal changes that occur after having a baby, these chemicals that control our feelings of happiness, sadness, and calmness can become out of balance. Brexanolone works by restoring that balance and reducing the symptoms of PPD.
Things you need to tell your doctor before undergoing this treatment
Before starting this treatment, the doctor needs to have a complete picture of your health condition. Therefore, it is very important that you tell him/her about the following without hiding anything.
| If you have these conditions | Why is that important? |
|---|---|
| If you drink alcohol | Combining alcohol and this medication can cause excessive drowsiness and other side effects. |
| If you have kidney disease | Because the kidneys remove drugs from the body, the dosage of the drug may need to be adjusted in cases of kidney disease. |
| If you have had suicidal thoughts, plans, or attempts (yours or someone in your family) | Because this medication can affect mood, it is essential that your doctor is aware of your mental health history. |
| If you have had an allergic reaction to brexanolone or other medicines, foods, or dyes | This is very important to prevent a possible allergic reaction to the medicine. |
| If you are pregnant, trying to get pregnant, or breastfeeding | This medication has the potential to pass to the baby through breast milk, so you should discuss this with your doctor. |
How is this treatment given?
This is not a medication that you can take home. This is a medication that is given as an infusion into a vein, like saline . This means that this treatment is given under the full supervision of a medical team in a hospital or clinic. This treatment is given for 60 hours, which is about two and a half days straight.
Before starting treatment, you will be given a special information leaflet (MedGuide) about this medicine. It is very important to read and understand it carefully.
Although this is usually a medicine given to adults, in some special cases, doctors may prescribe it to children as young as 15 years old. However, special precautions must be followed.
What if too much of the medicine is taken?
As this is given under medical supervision in a hospital, the risk of an overdose is very low. However, if you think this has happened, inform your medical team immediately. If necessary, they will inform the National Poisons Information Centre or the Emergency Treatment Unit (ETU) at the Colombo National Hospital .
Other things that may interact with this medicine
When taking this medicine, it may interact with other things you are taking. This means that the medicine may work differently or the side effects may increase.
Therefore, tell your doctor about all the medications you take (both those prescribed by a doctor and those you can buy at the pharmacy), the herbs you use, and the vitamins (supplements) you take, as well as if you smoke, drink alcohol, or use other illegal drugs. Don't hide anything .
The main things that can cause problems are:
- Alcohol
- Some medications for anxiety or sleep
- Narcotic medications for pain
- Other antidepressants
Things to consider during treatment
You need to pay special attention to yourself throughout this treatment.
Excessive drowsiness and dizziness:
This medicine may make you feel drowsy or dizzy . This is very important. While you are taking this medicine, your healthcare team will check you every two hours while you are awake to see if you are drowsy. If you feel that you are having trouble staying awake or are losing consciousness, you should tell your healthcare team right away.
Help with baby care:
For this reason, it is essential that a family member or caregiver stay with you to help care for your baby while you are receiving this treatment.
Driving and work requiring attention:
The medical team will decide when you can go home after the treatment is over. Even after you go home, you should not drive, use machinery, or do anything that requires concentration until the drowsiness and dizziness have completely gone.
Mental health:
Be aware of any new or worsening suicidal thoughts. If your mood or behavior changes suddenly, or if you feel your depression is getting worse, talk to your doctor right away.
What are the possible side effects?
Like any medicine, Brexanolone can cause side effects. Some of these are serious, while others are common.
| Type of side effect | Symptoms |
|---|---|
| Serious side effects that should be reported to the doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, difficulty breathing, fainting, dizziness, difficulty staying conscious. |
| Deterioration of mental state | Thoughts of suicide or harming yourself, increased depression, sudden changes in mood. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Dizziness | Dizziness |
| Drowsiness | |
| Dry mouth | |
| Flushing | |
Take-Home Message
- Brexanolone is a special treatment for postpartum depression (PPD) that is given intravenously in a hospital.
- Be sure to tell your doctor about all of your health conditions and all other medications you are taking.
- Excessive drowsiness or dizziness during treatment is a very important side effect. If you experience it, inform the medical team immediately.
- It is essential to have someone to help care for your child during treatment.
- Avoid drinking alcohol and driving during and after treatment until drowsiness has completely subsided.
- If your mental state worsens or you have thoughts of suicide, call your doctor immediately.
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