Citalopram increases pregnanolone sensitivity in patients with premenstrual syndrome: An open trial

Sundström, Inger; Bäckström, Torbjörn

doi:10.1016/s0306-4530(97)00064-4

Cited by 68 publications

(29 citation statements)

References 44 publications

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“…Allopregnanolone is a positive allosteric modulator of the GABA A receptor and it has been demonstrated by some (6, 7), but not by others (27±29), that a luteal phase decrease in plasma allopregnanolone concentration is associated with PMS. Others reports have suggested that there is a decrease in the GABAergic sensitivity to neurosteroid administration in the luteal phase in women with PMS compared with controls (30,31). Moreover, other receptors coupled to ion channels such as glycine receptors, nicotine acetylcholine receptors and 5-hydroxytryptamine 3 receptors have been identified as potential target for a modulation by various neuroactive steroids (32).…”

Section: Discussionmentioning

confidence: 99%

Neuroactive steroid-serotonergic interaction: responses to an intravenous L-tryptophan challenge in women with premenstrual syndrome

Rasgon

Serra²,

Biggio³

et al. 2001

European Journal of Endocrinology

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Objective: To evaluate the circulating concentrations of the neuroactive steroids in response to an i.v. L-tryptophan (L-TP) challenge across the menstrual cycle in women with premenstrual syndrome (PMS) and in controls. Method: An i.v. L-TP challenge was administered eight times during 1 month to five women with prospectively documented PMS and five age-and body mass-matched controls. Progesterone, allopregnanolone pregnenolone and 3a-5a-tetrahydrocorticosterone were assessed 15 and 0 min before, and at 30, 60 and 90 min after the challenge, across the menstrual cycle. Results: In response to L-TP challenge, only allopregnanolone concentrations were significantly increased across the cycle and this increase was of a greater magnitude in women with PMS. Pregnenolone and 3a-5a-tetrahydrocorticosterone concentrations were not affected in women with PMS or controls after L-TP challenge. Conclusions: The data provide evidence for possible interaction between the serotonergic system and the neuroactive steroid, allopregnanolone. Women with PMS demonstrated a more significant increase in allopregnanolone concentrations in response to L-TP challenge, which could be due to an initial low basal serotonergic tone in the luteal phase in the PMS group.

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Section: Discussionmentioning

confidence: 99%

Neuroactive steroid-serotonergic interaction: responses to an intravenous L-tryptophan challenge in women with premenstrual syndrome

Rasgon

Serra²,

Biggio³

et al. 2001

European Journal of Endocrinology

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“…Successful treatment with antidepressant medication was associated with reduced ALLO levels in a study by Freeman et al (97), but it is unclear whether baseline differences in ALLO or progesterone may account for this finding. Other studies showed neither diagnosis-related differences in ALLO or pregnanolone (277,337) nor any difference in ALLO levels in women with PMDD before and after successful treatment with citalopram (315). The use of different assays, antibodies, and methods of extraction across studies may account for some the variability in findings.…”

Section: Neurosteroid Regulation Of Mood In Pmddmentioning

confidence: 93%

Reproductive Steroid Regulation of Mood and Behavior

Schiller

Johnson

Abate

et al. 2016

Comprehensive Physiology

137

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In this article, we examine evidence supporting the role of reproductive steroids in the regulation of mood and behavior in women and the nature of that role. In the first half of the article, we review evidence for the following: (i) the reproductive system is designed to regulate behavior; (ii) from the subcellular to cellular to circuit to behavior, reproductive steroids are powerful neuroregulators; (iii) affective disorders are disorders of behavioral state; and (iv) reproductive steroids affect virtually every system implicated in the pathophysiology of depression. In the second half of the article, we discuss the diagnosis of the three reproductive endocrine-related mood disorders (premenstrual dysphoric disorder, postpartum depression, and perimenopausal depression) and present evidence supporting the relevance of reproductive steroids to these conditions. Existing evidence suggests that changes in reproductive steroid levels during specific reproductive states (i.e., the premenstrual phase of the menstrual cycle, pregnancy, parturition, and the menopause transition) trigger affective dysregulation in susceptible women, thus suggesting the etiopathogenic relevance of these hormonal changes in reproductive mood disorders. Understanding the source of individual susceptibility is critical to both preventing the onset of illness and developing novel, individualized treatments for reproductive-related affective dysregulation. © 2016 American Physiological Society. Compr Physiol 6:1135-1160, 2016e.

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“…Compared with low-severity patients, high-severity PMDD patients responded with less reduction in SEV and sedation response to midazolam as well as pregnanolone [24, 25]. Neurosteroids also appear to interact with the serotonergic system as the reduced pregnanolone sensitivity in PMDD patients was normalized during successful treatment with the serotonin reuptake inhibitor citalopram [45]. However, the underlying mechanism for premenstrual symptoms and adverse mood symptoms during progestagen addition appears not to be similar.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity to a Neurosteroid Is Increased during Addition of Progestagen to Postmenopausal Hormone Replacement Therapy

et al. 2001

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The aim of this study was to compare the pharmacodynamic response to a neuroactive steroid, pregnanolone, before and during different hormonal settings of postmenopausal hormone replacement therapy (HRT). Twenty-seven postmenopausal women with climacteric symptoms were administered HRT in a randomized, double-blinded, placebo-controlled crossover study. The women received 2 mg estradiol (E₂) continuously during four 28-day cycles and 10 mg medroxyprogesterone acetate (MPA), 1 mg norethisterone acetate (NETA) or placebo sequentially for the last 14 days in each cycle. The pharmacodynamic response to pregnanolone was assessed before treatment and during the last week of each treatment, by comparing the effects of intravenous pregnanolone (3α-hydroxy-5β-pregnan-20-one) on saccadic eye velocity (SEV), saccade deceleration, saccade latency and self-rated sedation. Throughout the study daily symptom rating scales were kept. During the progesta gen phase of the treatment cycles, negative mood symptoms and physical symptoms were increased, whereas positive mood symptoms were decreased. Compared to pretretreatment conditions, E₂ alone did not change the responsiveness to pregnanolone. During progestagen addition to E₂, the responsiveness to pregnanolone was increased. The sedation response increased compared to pretreatment conditions during both E₂ + MPA and E₂ + NETA treatment. Compared to E₂ treatment alone, addition of MPA increased the postpregnanolone effect on saccade deceleration, whereas the SEV response to pregnanolone was increased during E₂ + NETA treatment. It is concluded that pregnanolone sensitivity increases together with deterioration in mood symptoms during addition of progestagen to HRT.

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Citalopram increases pregnanolone sensitivity in patients with premenstrual syndrome: An open trial

Cited by 68 publications

References 44 publications

Neuroactive steroid-serotonergic interaction: responses to an intravenous L-tryptophan challenge in women with premenstrual syndrome

Neuroactive steroid-serotonergic interaction: responses to an intravenous L-tryptophan challenge in women with premenstrual syndrome

Reproductive Steroid Regulation of Mood and Behavior

Sensitivity to a Neurosteroid Is Increased during Addition of Progestagen to Postmenopausal Hormone Replacement Therapy

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