Brexanolone for postpartum depression

Zakhar Kogan
3 min readAug 17, 2023
Frontiers | Allopregnanolone, the Neuromodulator Turned Therapeutic Agent:  Thank You, Next?

Another take by Psychopharmacology Institute.

  • Brexanolone is a synthetic form of allopregnagolone, a GABA modulating neurosteroid
  • The study had 216 participants, all women 18–45 with de novo MDD in their third trimester or within the first 4 weeks following delivery
  • The drug was administered via a 60-hour injection (despite a half-life of roughly 9 hours)
  • The cumulative response rate of 81.4% in BRX versus 61.7% in PLA groups
  • All the other outcomes p<0.05 better in BRX group
  • The cost of such an injection is ~$34,000 before insurance and deductions (like WTF man)
  • BRX can apparently cross BBB when administered intranasally, however, a lot is lost (16,000 ng/mg in the olfactory bulb 670 ng/mg in the brain). The authors used cyclodextrin sulfobutylether — cyclodextrin to enhance the transport
  • More on BRX

Finally, generative agents!

The long-awaited agent simulations of human behavior…tadaa…the ones that use Time-Weighted Vector Retriever. By the way, here it is.

And here’s a demo which I’ve linked not once and not twice IIRC.

Alzheimer’s and gut

  • Some of the gut bacteria were found to be more prevalent in both AD patients and, in the present study, in the so-called preclinical stage
  • One of those are Faecalibacterium prausnitzii
Faecalibacterium Prausnitzii: An Anti-inflammatory Gut Microbe
  • Still, the authors tell us that in preclinical AD, FP is more abundant (the things you do without institutional access). 👀🧐🔎
  • Obviously, it’s detected more often; but is it more abundant on the average, and does this make real sense concerning its effects?

I wouldn’t run to conclusions and causal inference here. It may well be a correlation, or an adaptive change (say, as oxidative damage increases SOD/CAT/GPx expression, tau accumulation may slightly increase the butyrate producers, or some enzymes may produce more food for that phyla, etc.)

Tribalism

Just a wild thought:

May the cancel culture be rooted in the solitude everyone is experiencing (actually, not)? Maybe that’s more in line with interconnectedness exuberance and being fast to react?

How Long it Took for Popular Apps to Reach 100 Million Users

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