Effects of Gonadal Steroids in Women With a History of Postpartum Depression

Bloch, Miki; Schmidt, Peter J.; Danaceau, Merry A.; Murphy, Jean; Nieman, Lynnette K.; Rubinow, David R.

doi:10.1176/appi.ajp.157.6.924

Cited by 739 publications

(502 citation statements)

References 25 publications

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“…In order to test whether the change in hormone levels is indeed responsible for postpartum depression, one study treated females with the very high levels of estrogen associated with pregnancy followed by treatment with low levels associated with postpartum. Females either had a history of postpartum depression or did not (Bloch et al, 2000). As expected, treated females with a history developed dysphoric mood consistent with depression whereas those treated without a history did not.…”

Section: Female Depression and The Role Of Ovarian Hormonessupporting

confidence: 57%

Estrogen-mediated effects on depression and memory formation in females

Shors

Leuner

2003

Journal of Affective Disorders

150

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Women are twice as likely to suffer from depression as men. It has been proposed that the ovarian hormones estrogen and progesterone contribute to the higher incidence of this potentially debilitating disorder. Depression can also be accompanied by a loss of cognitive performance. Here we review estrogen-mediated effects on depression and memory formation in females. We propose that changes in levels of estrogen are associated with sex differences in learning as well as changes in affect prior to menses, immediately after pregnancy and during perimenopause and the menopausal transition. Finally, we discuss the animal model of depression known as 'learned helplessness' and describe research from our laboratory demonstrating that exposure to an acute stressful experience compromises a female's later ability to acquire certain types of new memories. This response to stressful experience is opposite to that observed in males and is dependent on the presence of estrogen, and more specifically-changing levels of estrogen. This observation indicates that females and males can use different hormonal and neural mechanisms to respond to the same emotional event and underscore the importance of studying the unique and changing biology of females, especially when considering treatment strategies for depression and stress-related illness.

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Section: Female Depression and The Role Of Ovarian Hormonessupporting

confidence: 57%

Estrogen-mediated effects on depression and memory formation in females

Shors

Leuner

2003

Journal of Affective Disorders

150

View full text Add to dashboard Cite

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“…A pharmacological model of PPD supports this hypothesis; simulating the postpartum state by administrating pregnancy levels of gonadal steroids and rapidly withdrawing them significantly increases the incidence of depression in women with a history of PPD more than in nondepressed women. Although statistically not significant, the scores of depression scales are higher in the withdrawal period in nonde-pressed women, indicating that these endocrine events provoke mood changes in postpartum women (6). However, the underlying neurobiological mechanisms that contribute to PPD have not been determined.…”

mentioning

confidence: 87%

A Postpartum Model in Rat: Behavioral and Gene Expression Changes Induced by Ovarian Steroid Deprivation

Suda

Segi-Nishida

Newton

et al. 2008

Biological Psychiatry

132

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Background-Postpartum depression (PPD) affects approximately 10% to 20% of women during the first 4 weeks of the postpartum period and is characterized by labile mood with prominent anxiety and irritability, insomnia,and depressive mood. During the postpartum period, elevated ovarian hormones abruptly decrease to the early follicular phase levels that are postulated to play a major role in triggering PPD. However, the underlying neurobiological mechanisms that contribute to PPD have not been determined.

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“…First, as reviewed above, allopregnanolone negatively modulates the HPA axis in animal models, and although null findings have been reported (Su et al, 1997;Bloch et al, 2000;Lombardi et al, 2004) where diagnosis-related differences exist, they suggest blunted HPA axis function in PMDD. For example, a number of studies have reported lower circulating ACTH or cortisol concentrations in PMDD women (Rabin et al, 1990;Redei & Freeman, 1993;Girdler et al, 1998), increased ACTH response to ovine CRF (consistent with lower endogenous CRF; Rabin et al, 1990), a delayed (Steiner et al, 1999) or blunted HPA axis response to serotonergic agents (Bancroft et al, 1991;Su et al, 1997), and the absence of the normal plasma cortisol and ACTH response to exercise stress in the luteal phase that is seen in non-PMDD women (Roca et al, 2003).…”

Section: Hpa Axis and Gaba A Receptor Function In Pmddmentioning

confidence: 99%

“…Histories of depression, which are more prevalent in PMDD women (Cohen et al, 2002), may provide a context of vulnerability for the dysphoric effects associated with steroid hormones (Rubinow, 2005). For example, Bloch et al (2000) demonstrated that euthymic women with a past history of postpartum depression experienced significant depression when exposed to high doses of hormone add-back and withdrawal, effects not seen in women with no prior history of depression. Divergent evidence suggests that in euthymic women, histories of depression are associated with persistent disturbance in HPA axis function (Young et al, 2000a(Young et al, , 2000b as well as thyroid axis function relative to never-depressed women.…”

Section: Histories Of Depression and Allopregnanolone Stress Responsimentioning

confidence: 99%

Neurosteroids in the context of stress: Implications for depressive disorders

Girdler

Klatzkin

2007

Pharmacology & Therapeutics

128

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Animal models indicate that the neuroactive steroids 3α,5α-THP (allopregnanolone) and 3α,5α-THDOC (allotetrahydroDOC) are stress responsive, serving as homeostatic mechanisms in restoring normal GABAergic and hypothalamic-pituitary-adrenal (HPA) function following stress. While neurosteroid increases to stress are adaptive in the short term, animal models of chronic stress and depression find lower brain and plasma neurosteroid concentrations and alterations in neurosteroid responses to acute stressors. It has been suggested that disruption in this homeostatic mechanism may play a pathogenic role in some psychiatric disorders related to stress. In humans, neurosteroid depletion is consistently documented in patients with current depression and may reflect their greater chronic stress. Women with the depressive disorder, premenstrual dysphoric disorder (PMDD), have greater daily stress and a greater rate of traumatic stress. While results on baseline concentrations of neuroactive steroids in PMDD are mixed, PMDD women have diminished functional sensitivity of GABA A receptors and our laboratory has found blunted allopregnanolone responses to mental stress relative to non-PMDD controls. Similarly, euthymic women with histories of clinical depression, which may represent a large proportion of PMDD women, show more severe dysphoric mood symptoms and blunted allopregnanolone responses to stress versus never-depressed women. It is suggested that failure to mount an appropriate allopregnanolone response to stress may reflect the price of repeated biological adaptations to the increased life stress that is well documented in depressive disorders and altered allopregnanolone stress responsivity may also contribute to the dysregulation seen in HPA axis function in depression.

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Effects of Gonadal Steroids in Women With a History of Postpartum Depression

Cited by 739 publications

References 25 publications

Estrogen-mediated effects on depression and memory formation in females

Estrogen-mediated effects on depression and memory formation in females

A Postpartum Model in Rat: Behavioral and Gene Expression Changes Induced by Ovarian Steroid Deprivation

Neurosteroids in the context of stress: Implications for depressive disorders

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