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Synthesis, Enzyme Localization, and Regulation of Neurosteroids
Published in Sheryl S. Smith, Neurosteroid Effects in the Central Nervous System, 2003
Though there is evidence of underlying changes in GABAA receptor function in PMDD, the question of what causes these phenomena remains. One plausible mechanism is that GABAA receptors may be regulated by endogenous modulators, such as the neuroactive metabolites of steroid hormones. Generally, steroid hormones, such as corticosterone and progesterone, exert their effects over a relatively long time by acting as transcription factors that regulate protein expression. These compounds can, however, also be further processed into neuroactive metabolites, which are known as neurosteroids since they have rapid actions at nerve cell membrane receptors and are synthesized in the brain.53 Neuroactive steroids include tetrahydrodeoxycorticosterone (THDOC), a derivative of corticosterone, and allopregnanolone and pregnanolone (3a-hydroxγ-5α-pregnane-20-one and 3a-hydroxγ-5β-pregnane-20-one, respectively), which are neuroactive metabolites of progesterone.
Benzodiazepines, Benzodiazepine Receptors, and Endogenous Ligands
Published in Siegfried Kasper, Johan A. den Boer, J. M. Ad Sitsen, Handbook of Depression and Anxiety, 2003
Some steroids, such as the progesterone metabolites pregnanolone (3α-hydroxy-5β - pregnan-20-one) and allopregnanolone (3α-hydroxy-5α -pregnan-20-one), are synthesized in the brain and their concentration varies depending on the hormonal situation (estrous cycle) of the individual [78]. From animal studies, it is known that these metabolites exhibit anxiolytic, hypnotic, and anticonvulsant effects. Their withdrawal during the es- trous cycle might contribute to the symptoms of premenstrual syndrome, such as anxiety and seizure susceptibility [79]. Reduced concentrations of these steroids might also contribute to postpartum or postmenopausal dysphoria [80].
A study of menstrual cycle effects on pain perception, haemodynamic response to laryngoscopy, and postoperative outcome in gynaecological laparoscopy
Published in Egyptian Journal of Anaesthesia, 2022
Mariam Hanna Mossad Samaan, Tarek Mohamed Ahmed Sarhan, Ramadan Abd El Azim Ammar, Tamer Hanafy Mahmoud, Ahmed Mohamed Ahmed El Shafie
Emergence agitation during the immediate postanesthetic period is common [50]. Despite being brief in duration, postoperative agitation (POA) is potentially harmful to the patient and the recovery staff [51]. Similarly, profound sedation in the post-anaesthesia care unit has been associated with increased adverse events, including respiratory complications [52,53]. Progesterone is thought to have a sedative effect via directly acting on the GABAA receptor through its metabolites (5α- and 5β-pregnanolone) [54]. Compared to progesterone, oestrogen seems to have the opposite effect on the GABA system in the central nervous system. It has been discovered that oestrogen has excitatory effects on the cerebellum and cerebral cortex and reduces GABAA-mediated inhibition in the hippocampus [55].
Contemporary management of unipolar depression in the perinatal period
Published in Expert Review of Neurotherapeutics, 2021
Bhuvaneshwari Sethuraman, Susan Thomas, Krishnamachari Srinivasan
Several neuroendocrine hormones like ovarian steroids have been implicated in the pathogenesis of perinatal depression. Reduced levels of gonadal steroids and oxytocin concentration in mid-gestation have been implicated in postpartum depression [34,35]. Exposure to oxytocin in the perinatal period increases the risk for postpartum depression [36]. Studies have reported decreased responsiveness to dexamethasone suppression test in women with postpartum depression suggesting dysfunction of HPA axis [37]. A recent study noted that plasma GABA levels were lower and progesterone and pregnanolone levels were higher in women at risk for postpartum depression compared to healthy controls and the interactions between GABA and neuroactive steroids may have a role in the pathophysiology of postpartum depression [38].
Serum testosterone levels in bipolar and unipolar depressed female patients and the role of medication status
Published in International Journal of Psychiatry in Clinical Practice, 2020
Mónica Flores-Ramos, Claudia Becerra-Palars, Consuelo Hernández González, Roberto Chavira, Norma Bernal-Santamaría, Lucía Martínez Mota
Some limitations can be suggested regarding the present study. The first, size sample was limited, the design was cross-sectional, and we did not use a structured interview to confirm MDD or BD diagnosis. Additionally, as only one measure of testosterone was obtained, it was impossible to know if higher levels of TT in BP women are sustained along the course of the disorder. Other limitation is that in the present design, precursors (i.e., pregnanolone or dehydroepiandrosterone) or metabolites (i.e., oestradiol, dihydrotestosterone) of testosterone were not quantified, and some of them would highlight changes in steroid metabolism in affective disorders. Finally, data from a control group and comparisons with men are needed to have enough information about the role of testosterone in affective disorders as well as the role of medication in testosterone levels.