TY - JOUR
T1 - Neurosteroids in the Pathophysiology and Treatment of Mood and Anxiety Disorders
AU - Perkins, Elizabeth C.
AU - Newport, D. Jeffrey
N1 - Funding Information:
Dr. Perkins has nothing to disclose. Dr. Newport has received research support from Eli Lilly & Company (Lilly), Glaxo SmithKline (GSK), Janssen, National Alliance for Research on Schizophrenia and Depression (NARSAD), National Institutes of Health (NIH), SAGE, Takeda Pharmaceuticals, and Wyeth. He has served on speakers’ bureaus for Astra-Zeneca (AZ), Lilly, GSK, Pfizer and Wyeth, and advisory boards for GSK and Janssen. Neither he nor family members have ever held equity positions in biomedical or pharmaceutical corporations.
Publisher Copyright:
© 2018, Springer Nature Switzerland AG 2018.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Purpose of reviewNeurosteroids have been implicated in the pathophysiology of mood, anxiety, and trauma-related disorders, as well as syndromes specific to women such as premenstrual syndrome, premenstrual dysphoric disorder, postpartum depression, peri- and post-menopausal depression. This review summarizes the role of neurosteroids in the neurobiology of stress and that of pharmaceuticals that modulate neurosteroids in the treatment of these disorders. Recent findingsNeurosteroids may provide novel treatments of mood and anxiety disorders. While endogenous neurosteroids have poor bioavailability, there are other means by which neurosteroid activity may be pharmacologically modulated. Various synthetic neurosteroids are under investigation. In addition, naturally produced exogenous molecules that positively modulate neurosteroid action at GABA A , as well as agents targeting enzymes that degrade or promote synthesis of neurosteroids, are being used to manipulate neurosteroid systems. SummaryNeurosteroids act on a wide variety of neuroreceptors, particularly GABA A , playing roles in both homeostasis and the pathophysiology of stress. There is evidence that many pharmaceuticals used for mood and anxiety disorders including antidepressants, antipsychotics, and mood stabilizers may be effective secondary to their ability to modulate neurosteroids. Synthetic versions of neurosteroids, as well as pharmaceuticals that act indirectly to increase synthesis of neurosteroids, are being studied as possible treatments for a variety of mood and anxiety disorders.
AB - Purpose of reviewNeurosteroids have been implicated in the pathophysiology of mood, anxiety, and trauma-related disorders, as well as syndromes specific to women such as premenstrual syndrome, premenstrual dysphoric disorder, postpartum depression, peri- and post-menopausal depression. This review summarizes the role of neurosteroids in the neurobiology of stress and that of pharmaceuticals that modulate neurosteroids in the treatment of these disorders. Recent findingsNeurosteroids may provide novel treatments of mood and anxiety disorders. While endogenous neurosteroids have poor bioavailability, there are other means by which neurosteroid activity may be pharmacologically modulated. Various synthetic neurosteroids are under investigation. In addition, naturally produced exogenous molecules that positively modulate neurosteroid action at GABA A , as well as agents targeting enzymes that degrade or promote synthesis of neurosteroids, are being used to manipulate neurosteroid systems. SummaryNeurosteroids act on a wide variety of neuroreceptors, particularly GABA A , playing roles in both homeostasis and the pathophysiology of stress. There is evidence that many pharmaceuticals used for mood and anxiety disorders including antidepressants, antipsychotics, and mood stabilizers may be effective secondary to their ability to modulate neurosteroids. Synthetic versions of neurosteroids, as well as pharmaceuticals that act indirectly to increase synthesis of neurosteroids, are being studied as possible treatments for a variety of mood and anxiety disorders.
KW - Allopregnanolone
KW - Anxiety
KW - DHEA
KW - Depression
KW - Early life adversity
KW - Estrogen
KW - GABA
KW - Neurosteroid
KW - Progesterone
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U2 - 10.1007/s40501-018-0159-8
DO - 10.1007/s40501-018-0159-8
M3 - Review article
AN - SCOPUS:85065786794
VL - 5
SP - 377
EP - 400
JO - Current Treatment Options in Psychiatry
JF - Current Treatment Options in Psychiatry
SN - 2196-3061
IS - 4
ER -