Action by and sensitivity to neuroactive steroids in menstrual cycle related CNS disorders

Psychopharmacology (Berl). 2006 Jun;186(3):388-401. doi: 10.1007/s00213-005-0185-2. Epub 2005 Dec 15.

Abstract

Neuroactive steroids are a large group of substances having effect in the brain and on brain function. The steroids most studied are allopregnanolone (ALLO), tetrahydrodesoxycorticosterone (THDOC), pregnenolone sulfate (PS) dihydroepiandrosteronesulfate (DHEAS), and estradiol (E2). ALLO and THDOC are called gamma-aminobutyric acid (GABA) steroids as they are positive modulators of the GABAA receptor in a similar way as benzodiazepines, barbiturates, and alcohol. GABA steroids not only have similar behavioral effects as benzodiazepines and barbiturates but, possibly, also similar adverse effects as well. This review aims to elucidate the possible role that neuroactive steroids play in the development of mood disorders in women. One of the most clear-cut examples of the interaction between mood, neuroactive steroids, and the GABA system is premenstrual dysphoric disorder (PMDD), which is a cluster of negative mood symptoms occurring during the luteal phase of the menstrual cycle in 2-6% of reproductive women. Furthermore, certain women also experience adverse mood effects during sequential progestin addition to postmenopausal estrogen treatment, which is why the role of neuroactive steroids in postmenopausal women is also addressed in this review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / metabolism
  • Central Nervous System Diseases / etiology
  • Central Nervous System Diseases / metabolism
  • Estrogens / therapeutic use
  • Female
  • GABA Modulators / adverse effects
  • GABA Modulators / metabolism
  • Hormone Replacement Therapy / adverse effects
  • Humans
  • Menopause / metabolism
  • Mood Disorders / etiology*
  • Mood Disorders / metabolism
  • Ovary / metabolism
  • Pregnanes / adverse effects
  • Pregnanes / metabolism*
  • Pregnanes / therapeutic use
  • Premenstrual Syndrome / etiology
  • Premenstrual Syndrome / metabolism
  • Receptors, GABA-A / metabolism

Substances

  • Estrogens
  • GABA Modulators
  • Pregnanes
  • Receptors, GABA-A