Neuroactive Steroids and Perinatal Depression: a Review of Recent Literature
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Purpose of Review
The purpose of this review is to provide a theoretical explanation and a review of the recent literature concerning the role of neuroactive steroids in perinatal depression, and to use this information to suggest future directions of research.
The bulk of the evidence on neuroactive steroids in perinatal depression concerns allopregnanolone. Recent studies have been mixed, with some studies finding a direct correlation between lower levels of allopregnanolone and increased depressive symptoms but other studies finding no relationship. Evidence concerning other neuroactive steroids and perinatal depression is sparse.
Additional research is needed with larger sample sizes and better characterization across the perinatal period (rather than cross-sectionally). Because some studies point to a lag between neuroactive steroid dysregulation and subsequent symptoms, future research should consider interactions with other aspects of neuroactive steroid physiology, such as synthetic enzymes or receptor plasticity.
KeywordsNeuroactive steroids Neurosteroids Allopregnanolone Perinatal depression Postpartum depression
The authors would like to acknowledge the help of Julie Nanavati, an informationist at Johns Hopkins University who assisted with the literature search, and of Cate Kiefe, an artist with the Department of Medical Illustration at Johns Hopkins, who created the figure.
Compliance with Ethical Standards
Conflict of Interest
Katherine McEvoy and Lauren M. Osborne declare no conflict of interest.
Jennifer L. Payne reports grants and personal fees from SAGE Therapeutics and has done legal consulting for Eli Lilly and Abbott Pharmaceuticals. In addition, Dr. Payne holds a patent for epigenetic biomarkers of postpartum depression.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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