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Have recently read of FDA approval of allopregnanolone for postpartum depression. What recommendations for the breastfeeding mother?
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Midwife:
Should be good, but is only indicated for refractory postpartum depression. Brexanolone is a neuroactive steroid modulator similar in structure to allopregnanolone. It is active at the steroid gamma-aminobutyric acid (GABA) receptor. The manufacturer reports that data from a lactation study in 12 women who received intravenous doses of 90 mg/kg/hour for 60 hours, that levels of brexanolone transferred to breastmilk was exceedingly low with an RID of 1-2% of maternal dose. In addition, because brexanolone has low oral bioavailability (<5%) in adults, infant exposure is expected to be low. Concentrations of brexanolone in breast milk were at low levels (<10 ng/mL) in >95% of women by 36 hours after the end of the infusion. Adverse events in breastfeeding infants are not expected.
Tom Hale Ph.D.
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