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Neurosteroids in the Pathophysiology and Treatment of Mood and Anxiety Disorders

  • Mood Disorders (C Nemeroff and J Newport, Section Editors)
  • Published:
Current Treatment Options in Psychiatry Aims and scope Submit manuscript

Abstract

Purpose of review

Neurosteroids 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 findings

Neurosteroids 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 GABAA, as well as agents targeting enzymes that degrade or promote synthesis of neurosteroids, are being used to manipulate neurosteroid systems.

Summary

Neurosteroids act on a wide variety of neuroreceptors, particularly GABAA, 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.

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Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Elizabeth C. Perkins M.D. & D. Jeffrey Newport M.D., M.S., M.Div.

  2. Department of Obstetrics & Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA

    D. Jeffrey Newport M.D., M.S., M.Div.

  3. Don Soffer Clinical Research Center, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1446, Miami, FL, 33136, USA

    D. Jeffrey Newport M.D., M.S., M.Div.

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  1. Elizabeth C. Perkins M.D.
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  2. D. Jeffrey Newport M.D., M.S., M.Div.
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Correspondence to D. Jeffrey Newport M.D., M.S., M.Div..

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Conflict of Interest

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.

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This article is part of the Topical Collection on Mood Disorders

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Perkins, E.C., Newport, D.J. Neurosteroids in the Pathophysiology and Treatment of Mood and Anxiety Disorders. Curr Treat Options Psych 5, 377–400 (2018). https://doi.org/10.1007/s40501-018-0159-8

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