• Wei Zheng, Dong-Bin Cai, Kang Sim, Gabor S Ungvari, Xiao-Jiang Peng, Yu-Ping Ning, Gang Wang, and Yu-Tao Xiang.
• The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
• Psychiatry Res. 2019 Sep 1; 279: 83-89.

ObjectivesTo systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD).MethodsRandomized controlled trials (RCTs) were included.ResultsTwo articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95%CI 1.03-1.73), peaked at 36 h (RR = 1.50, 95%CI 1.06-2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95%CI 1.01-1.73). Similarly, PPD women treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95%CI 1.03-3.34), peaking at 60 h (RR = 2.20, 95%CI 1.31-3.70) and lasting until 72 h (RR = 1.96, 95%CI 1.41-2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95%CI 1.35-5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo.ConclusionA single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.Copyright © 2019 Elsevier B.V. All rights reserved.

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