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Ali M, Ullah I, Diwan MN, Aamir A, Awan HA, Waris Durrani A, Qudrat QU, Shoib S, De Berardis D. Zuranolone and its role in treating major depressive disorder: a narrative review. Horm Mol Biol Clin Investig 2023:hmbci-2022-0042. [PMID: 36848317 DOI: 10.1515/hmbci-2022-0042] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/11/2022] [Indexed: 02/28/2023]
Abstract
Major Depressive Disorder (MDD) is a mood disorder classified as a persistent depressive mood and loss of interest lasting for more than two weeks and accompanied by a list of symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria. MDD affects approximately 264 million people worldwide and is the most prevailing form of neuropsychiatric disorder. Owing to the probable hypothesized pathophysiology of MDD being an outcome of abnormalities in the amino acid neurotransmitter system, including glutamate (the primary excitatory neurotransmitter) and γ-aminobutyric acid (GABA), SAGE-217 (Zuranolone) is being evaluated as a possible therapeutic treatment for MDD. Zuranolone is a synthetic, neuroactive steroid (NAS) and positive allosteric modulator (PMA) of GABAA receptors, regulating both synaptic and extra-synaptic release of GABA. It is administered as a once-daily oral dose for 2 weeks due to its low-moderate clearance. A change in total HAM-D score from baseline was the primary end-point of all the trials. A phase II trial conducted to evaluate the efficacy and safety of Zuranolone (30 mg, once-daily dose), described a significant reduction in total HAM-D score at day 14 and reported the drug to be well tolerated with headache, dizziness, nausea, and somnolence as the most common adverse events (AE). Additional phase III trials were also conducted to evaluate similar outcomes, the interim topline results of which have been released. Consequently, this article attempts to briefly analyze the pharmacology of Zuranolone, review the available clinical data and outcomes regarding its use, and evaluate its place as a prospective novel therapy in the effective management of MDD.
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Affiliation(s)
- Muneeza Ali
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan.,Department of Internal Medicine, Peshawar, Pakistan
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Mufaddal Najmuddin Diwan
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan.,Department of Internal Medicine, Peshawar, Pakistan
| | - Alifiya Aamir
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan.,Department of Internal Medicine, Peshawar, Pakistan
| | - Hashir Ali Awan
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan.,Department of Internal Medicine, Peshawar, Pakistan
| | - Abdul Waris Durrani
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Qudrat Ullah Qudrat
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India.,Sharda University, Greater Noida, Uttar Pradesh, India.,Mind Wellness Center, Nawab Bazar, Srinagar, India
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
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