Zulresso (Brexanolone) Side Effects: Common, Serious, & Long Term

What Is Zulresso (Brexanolone) & How Is It Used?

Zulresso (brexanolone) belongs to the class of drugs called neuroactive steroids that impact gamma-aminobutyric acid (GABA) receptors.¹ This medication is prescribed as an antidepressant for the treatment of postpartum depression in individuals 15 years and older.² Zulresso is given via a continuous infusion over 60 hours and requires continuous monitoring by a healthcare professional.³

While the exact mechanism of Zulresso’s action is not fully understood, it is likely due to the influences on certain chemicals in the brain. It is worth noting that Zulresso is classified as a controlled substance, subject to strict regulation due to its potential for abuse and dependence.

Serious Side Effects of Zulresso

Zulresso is typically well tolerated, but serious side effects of Zulresso are possible, requiring immediate medical attention. Zulresso can cause excessive sleepiness and loss of consciousness, requiring a break in treatment or reduction of the medication dosage. If serious or persistent side effects occur, it is important to notify your healthcare provider immediately.

Serious side effects of Zulresso include:^{1, 3, 4}

• Fainting or loss of consciousness
• Excessive sleepiness
• Racing heartbeat
• Suicidal thoughts or behaviors
• Allergic reactions

*All medications, including Zulresso, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Common Side Effects of Zulresso

Most common side effects are mild and can resolve or diminish with time. The side effects that occur vary from person to person. It is crucial to inform a healthcare provider of any side effects you are experiencing, especially if the side effects are severe or persistent. This will ensure you are getting the maximum benefit from the medication.

Common side effects of Zulresso include:^{1, 3, 4}

• Dry mouth
• Dizziness
• Mild sleepiness
• Hot flashes
• Fatigue
• Mouth or throat pain
• Heartburn

*All medications, including Zulresso, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Frequently Asked Questions (FAQ) About Zulresso Side Effects

Common questions about Zulresso side effects often include the duration of side effects, how long it stays in the body, and how to prevent the side effects. It is important to remember that individual experiences will vary. Discussing your concerns with a healthcare provider is important as they can offer personalized support and advice. A healthcare provider will be available throughout the infusion to monitor for side effects.

How Long Do Zulresso Side Effects Last?

The duration of Zulresso side effects can vary from person to person. The duration can influenced by factors such as an individual’s response and medical history. Most often, the side effects will resolve once the treatment ends.

How Long Does Zulresso Stay in Your System?

Zulresso has a half-life of approximately 9 hours.¹ The half-life of a medication is the time it takes for half of the drug to be removed from the body. After 4-5 half-lives, the amount of drug left in the body is not considered to be significant. So, after infusion, Zulresso will stay in the system for approximately 36-45 hours.

How Can I Reduce My Risk of Side Effects?

To reduce the risk of side effects, it is essential to notify your healthcare provider of all medications, supplements, and herbs that you are taking. When receiving the infusion, let your healthcare provider know of any adverse effects, as they may need to adjust your treatment course to limit worsening side effects.

Zulresso Warnings & Precautions

Zulresso comes with a few warnings and precautions to be aware of before starting treatment. As you will be closely monitored during the infusion, your healthcare provider will be watching for these potential effects. If these effects occur, the Zulresso infusion may need to be stopped or paused until the effects resolve.

Precautions for taking Zulresso include:¹

• Suicidal thoughts & behavior: Although rare, increased suicidal thoughts and behaviors are a risk when taking antidepressants. The risk of developing suicidal thoughts and behaviors when receiving treatment with Zulresso is unknown but should be monitored closely. It is important to know how to spot warning signs of suicide and to seek immediate medical attention if this occurs.
• Excessive sedation and sudden loss of consciousness: Zulresso can cause excessive sedation and loss of consciousness in some individuals. This typically resolves after 15-60 minutes once the infusion is stopped. The infusion can be restarted at a lower dose, or it may be discontinued altogether.
• Pregnancy: Zulresso may cause harm to a fetus if used during pregnancy. However, the risk is not fully known. It is important to discuss with your healthcare provider regarding the risk and benefits of using Zulresso if pregnant.
• Breastfeeding: Zulresso is excreted in breast milk at low levels, but the risk to infants is not fully known. The health benefits of breastfeeding, the need for Zulresso, and the potential side effects should be discussed with a healthcare provider.
• Abuse and dependence: Zulresso is a controlled substance and is provided only through a monitored infusion. This limits the risk of abuse and dependence, but this should still be considered in those with a history of substance abuse.

Allergic Reactions

Allergic reactions to Zulresso are rare but can occur. These reactions can range from mild to severe and may require discontinuation of the Zulresso infusion. Close monitoring by a healthcare provider is important when receiving the infusion. If you notice any allergic symptoms, it is important to notify the healthcare provider right away.

Allergic reactions to Zulresso include:

• Difficulty breathing
• Wheezing
• Hives
• Itching
• Swelling of mouth, tongue, or lips.

If you are experiencing an allergic reaction, notify your healthcare team immediately. Do not hesitate to mention how you are feeling to the healthcare provider, as they may need to stop the infusion to lower the dose.

How to Manage Side Effects

Zulresso is given via a continuous infusion, requiring close monitoring throughout the treatment. Notify your healthcare team of any side effects that occur, as this may impact your treatment course. If side effects are not dangerous, no change may be necessary. However, for dangerous or severe side effects, the infusion may need to be stopped, or the dose may need to be lowered.

Drowsiness

If you are experiencing drowsiness, notify your healthcare team. The infusion may need to be paused until these side effects resolve, and if restarted, it may need to be restarted at a lower dose.

Worsened Depression or Suicidal Thoughts

Notify your healthcare team if you notice any sad mood or worsening depression, especially if you are experiencing suicidal thoughts or worsening depression. This may occur during the infusion or after treatment.

Dizziness

If you are experiencing dizziness, it is important to let your healthcare team know how you are feeling. They may want to lower the infusion dose or make sure you are in a safe position to limit the risk of falling.

Hot Flashes

Hot flashes may occur when receiving the Zulresso infusion. Notify your healthcare team if these occur, as they will be able to help make you more comfortable.

It is important to remember that side effects can vary from person to person, and the lists provided may not encompass all potential reactions. It is important to discuss the risks and benefits of Zulresso with your healthcare provider. They will be able to offer personalized recommendations to help you make an informed decision regarding your treatment plan.

Questions to Ask Your Healthcare Provider About Zulresso Side Effects

Individuals considering Zulresso should ask about the potential side effects when consulting with their doctor, psychiatrist, and therapist. It is important to be aware of the common and severe side effects, how to recognize them, and what will be done if they occur. If you are in need of a healthcare provider or need to change providers, online psychiatry services are a great option. These platforms connect you with reputable providers to manage your treatment journey.

Questions to ask your care team about Zulresso side effects:

• How long will it take for me to adjust to Zulresso?
• Am I at risk for more serious symptoms if I am already taking other anxiety /depression medications?
• Is there anything I should tell my therapist about this new medication?
• Who should I tell if I am experiencing side effects?
• When is it safe to resume normal activities like driving or operating machinery?
• Are there any dietary restrictions or considerations after being treated with Zulresso?
• What are the potential risks of Zulresso use during pregnancy?
• What alternative treatments are there for postpartum depression?

In My Experience

In my experience, receiving treatment for postpartum depression is very important. For those experiencing postpartum depression, it is a challenging time, but there are treatments available. Zulresso is one of those treatments and should be discussed with a healthcare provider if you experience postpartum depression. My advice to those with postpartum depression is to maintain open dialogue with their healthcare providers, follow prescribed guidelines, and never hesitate to seek help if experiencing side effects or worsening symptoms. With the right support and guidance, there is hope for improved mental health and well-being for those with postpartum depression.