Zulresso (brexanolone) is a sterile solution of allopregnanolone for intravenous infusion in development for the treatment of postpartum depression (PPD). Allopregnanolone is a positive allosteric modulator of the neurotransmitter gamma-aminobutyric acid (GABAA) receptors. Plasma allopregnanolone concentrations rise in concert with progesterone throughout pregnancy, reaching the highest physiological concentrations in the third trimester. After childbirth, these concentrations decrease abruptly. Failure of GABAA receptors to adapt to these changes may have a role in triggering PPD. Although the cause of PPD is not entirely understood, it is proposed that treatment of women with PPD with doses of allopregnanolone that result in serum concentrations equivalent to those present during the third trimester may lessen PPD symptoms.
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