Methods of treating certain depressive disorders and delirium tremens
The disclosure provides a method of treating a patient having postpartum depression, premenstrual dysphoric disorder, menopausal depression, or delirium tremens comprising administering an effective amount of an injectable neurosteroid formulation to the patient. In certain embodiments the injectable neurosteroid formulation is an injectable ganaxolone formulation. Two types of injectable neurosteroid formulations may be used in the disclosed methods. The first such formulation is an injectable formulation containing ganaxolone and sulfobutyl ether β-cyclodextrin in a 1:1 inclusion complex. The second such formulation is an injectable neurossteroid formulation comprising a neurosteroid, preferably ganaxolone, but which may be a neurosteroid selected from allopregnanolone, ganaxolone, alphaxalone, alphadolone, hydroxydione, minaxolone, pregnanolone, tetrahydrocorticosterone, and combinations of the foregoing; a surface stabilizer selected from hydroxyl ethyl starch, dextran, and povidone; and a surfactant.
1. A method of treating postpartum depression, premenstrual dysphoric disorder, menopausal depression, or delirium tremens comprising administering an effective amount of an neurosteroid formulation to a patient in need thereof; wherein the neurosteroid formulation is an ganaxolone formulation comprising
a) water;
b) sulfobutyl ether-β-cyclodextrin (CAPTISOL) and ganaxalone, wherein the ratio of sulfobutyl ether-β-cyclodextrin to ganaxolone wherein weight to weight (w/w) ratio of sulfobutyl ether-β-cyclodextrin is about 52:1 or greater; and
c) a buffer, the formulation having a pH of 6.8 to 7.6.
2. The method of claim 1 wherein the ganaxalone formulation is an intravenous formulation.
3. The method of claim 1 , wherein ulation comprises 0.1 mg/mL to 15 mg/mL ganaxolone and 5.5 mg/ mL to 800 mg/ml sulfobutyl ether-β-cyclodextrin.
4. The method of claim 2 , wherein the patient is administered 0.1 mg/kg to 200 mg/kg neurosteroid as a single bolus dose.
5. The method of claim 4 , wherein the single bolus dose provides a sufficient amount of ganaxolone to provide a plasma C max of ganaxolone of at least 60 ng/ mL in the patient.
6. The method of claim 2 , wherein the patient is administered the formulation as an intravenous infusion for 1 hour to 10 consecutive days at a rate of 1 to 10 mg neurosteroid/hr/kg, with or without an initial bolus dose.
7. The method of claim 2 , wherein the intravenous neurosteroid formulation administered to the patient is a ganaxolone infusion administered at the rate of 2 mg/hr to 4 mg/ hr.
8. The method of claim 2 , wherein the intravenous neurosteroid formulation administered to the patient is a ganaxolone infusion administered at a rate sufficient to provide a steady state plasma concentration of 50 ng/ ml to 100 ng/ ml.
9. The method of claim 7 , wherein the intravenous neurosteroid formulation is a ganaxolone formulation which is administered at for 36 hrs to 72 hrs.
10. The method of claim 1 , wherein the patient is a patient having premenstrual dysphoric disorder and the patient is administered a daily oral dose of ganaxolone of 100 mg to 2000 mg administered from day 18-24 of the patients menstrual cycles until day 2-4 of the patient's menstrual cycle.
11. The method of claim 1 , wherein the patient is a patient having menopausal depression and the patient is administered a daily oral dose of ganaxolone of 100 mg to 2000 mg ganaxolone.
12. The method of claim 11 , wherein the patient is administered the ganaxolone in combination with an SSRI or SNRI antidepressant.
13. The method of claim 1 , wherein the patient is a patient having delirium tremens and the patient is administered a ganaxolone intravenous infusion at a rate of 50 mg/ hr to 500 mg/hr for 1 to 5 days.
14. The method of claim 13 , wherein the patient is administered the ganaxolone in combination with an intravenous benzodiazepine infusion.