NRI Researcher Contributed to First Pill for Postpartum Depression in Women

Dr. Samba Reddy has pioneered research on neurosteroids that paved the way for the new oral pill for postpartum depression in women.  

COLLEGE STATION: On August 4, 2023, the United States Food and Drug Administration (FDA) approved Zuranolone (Zurzuvae) as the first oral neurosteroid treatment for postpartum depression (PPD) in women. PPD is a serious mental health condition that can affect new mothers after giving birth. It can cause symptoms such as sadness, anxiety, despair, and thoughts of self-harm or harming one’s child.

 Dr. Samba Reddy, an Indian scientist working at the Texas A&M University School of Medicine, has made groundbreaking contributions to neurosteroid replacement therapy (NRT) research, paving the way for the development of this new medicine for PPD.

Neurosteroids are steroids that are produced in the brain and play a vital role in regulating brain function. Dr. Reddy explains that “neurosteroids are released each time we undergo mild stress, and that means that they are ‘stress-busters.'” During pregnancy, levels of one particular neurosteroid, allopregnanolone, increase. However, after childbirth, neurosteroid levels fall, which can lead to chemical imbalances in the brain and PPD.

Dr. Reddy’s research led to the development of intravenous allopregnanolone for the treatment of PPD. This medication, renamed brexanolone, was approved in 2019 as the first PPD treatment to be administered in certified health facilities. This landmark journey on brexanolone, from concept to clinic, was archived in the journal Psychopharmacology.

 “Ten percent of mothers experience PPD, but before NRT-based neurosteroid therapeutics, we didn’t have any medicine that worked rapidly,” Dr. Reddy said. “After childbirth, they would have to wait weeks for existing antidepressants, such as fluoxetine or other SSRIs or SNRIs,  to take effect, so the neurosteroid therapy is filling this gap.”

 The treatment takes effect within just a few hours, which is in stark contrast to the traditional antidepressants that have been historically used to treat PPD, which take three or four weeks.

 However, brexanolone is an intravenous medication, which means that patients must stay in the hospital for three days to receive the infusion. This can be a barrier to treatment for many new mothers due to time, financial, and social constraints.

 Zuranolone, an oral allopregnanolone analog, addresses these limitations. It is administered by mouth in a single 14-day course, allowing new mothers to take the medication and recover in the comfort of their own homes. Similar to brexanolone, zuranolone replaces the loss of natural neurosteroids and improves the function of the extrasynaptic and synaptic GABA-A receptors, which regulate mood and behavior.

 Dr. Reddy’s research on neurosteroids has spanned over two decades. He is credited with developing the concept of neurosteroids as a new class of neuromodulators. His work has led to the development of new therapeutic products, such as brexanolone and zuranolone, which have the potential to improve the lives of millions of people suffering from brain and mental health disorders.

 The neurosteroid concept he and his collaborators came up with over two decades ago has finally enabled the creation of a new type of product that is accessible to the public as zuranolone. The clinical approval of zuranolone recognizes Dr. Reddy’s pioneering research on neurosteroids, the endogenous molecules that regulate neuronal excitability, seizure and mood by rapidly interacting with ionotropic GABA-A receptors on neurons.

Dr. Reddy’s pioneering research on neurosteroids has ushered in a new era of research with the potential to develop new treatments for other neurological and psychiatric conditions. The clinical approval of zuranolone is a testament to his groundbreaking work and a major step forward in the treatment of postpartum depression.