Drugs Information: Brexanolone

Basic Information

ID DDInter230
Drug Type small molecule
Molecular Formula C21H34O2
Molecular Weight 318.501
Description As of March 2019, brexanolone - developed and made available commercially by Sage Therapeutics Inc. as the brand name product Zulresso - is the first drug to have ever been approved by the US FDA specifically for the treatment of postpartum depression (PPD) in adult females [F4066]. Since PPD, like various other types of depression, is characterized by feelings of sadness, worthlessness or guilt, cognitive impairment, and/or possibly suicidal ideation, it is considered a life-threatening condition [F4072]. Studies have consequently found that PPD can genuinely have profound negative effects on the maternal-infant bond and later infant development [F4072, A176080, A176083]. The development and availability of brexanolone for the treatment of PPD in adult females subsequently provides a new and promising therapy where few existed before [F4066]. In particular, the use of brexanolone in treating PPD is surrounded with promise because it acts in part as a synthetic supplement for possible deficiencies in endogenous brexanolone (allopregnanolone) in postpartum women susceptible to PPD whereas many commonly used anti-depressive medications elicit actions that may modulate the presence and activity of substances like serotonin, norepinephrine, and/or monoamine oxidase but do not mediate activities directly associated with PPD like natural fluctuations in the levels of endogenous neuroactive steroids like allopregnanolone [F4063]. And finally, although brexanolone may also be undergoing clinical trials to investigate its abilities to treat super-refractory status epilepticus, it appears that some such studies have failed to meet primary endpoints that compare success in the weaning of third-line agents and resolution of potentially life-threatening status epilepticus with brexanolone vs. placebo when added to standard-of-care [L5750].
ATC Classification -
IUPAC Name 1-[(1S,3As,3Br,5As,7R,9As,9Bs,11As)-7-Hydroxy-9A,11A-Dimethyl-Hexadecahydro-1H-Cyclopenta[A]Phenanthren-1-Yl]Ethan-1-One
InChI Inchi=1S/C21H34O2/C1-13(22)17-6-7-18-16-5-4-14-12-15(23)8-10-20(14,2)19(16)9-11-21(17,18)3/H14-19,23H,4-12H2,1-3H3/T14-,15+,16-,17+,18-,19-,20-,21+/M0/S1
InChI Key AURFZBICLPNKBZ-SYBPFIFISA-N
Canonical SMILES [H][C@@]1(CC[C@@]2([H])[C@]3([H])CC[C@@]4([H])C[C@H](O)CC[C@]4(C)[C@@]3([H])CC[C@]12C)C(C)=O
Useful Links DrugBank ChEMBL PubChem

Interactions with Brexanolone

Severity level ID Name Mechanism Detail