用神经类固醇治疗产后抑郁症

Reda Stankevičiūtė, R. Strumila
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摘要

神经类固醇(如异孕烷酮)主要是在中枢神经系统中合成的物质,会影响大脑中发生的过程。神经类固醇水平的波动会导致焦虑和敏感性增加。神经类固醇合成的显著减少通常发生在围经期和产后,此时孕酮水平非常低。据认为,体内缺乏神经类固醇是产后抑郁症的主要原因之一。产后抑郁症(PPD)是妇女在产后期间出现的一种抑郁症。已开展的临床研究结果表明,Brexanolone(异孕酮的水溶性制剂)可有效治疗产后抑郁症。根据 HAMD-17 抑郁量表的评估,与安慰剂组相比,接受注射神经类固醇的 PGD 妇女能更有效、更快地缓解产后抑郁。随后还进行了神经类固醇片剂(Zuranolone)的研究,结果同样显示了对产后抑郁症的良好疗效。此外,在使用神经类固醇注射剂和片剂的治疗过程中,患者的副作用相对较少且不具威胁性。这表明,神经类固醇在治疗产后抑郁症方面的益处可能大于潜在的危害,因此欧洲的精神病学实践可能会考虑并将其纳入治疗范围。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pogimdyminės depresijos gydymas neurosteroidais
Neurosteroids, such as allopregnanolone, are primarily synthesized substances in the central nervous system which influence processes occurring in the brain. Fluctuations in the levels of neurosteroids can result in an increased anxiety and heightened sensitivity. Significant reduction in neurosteroid synthesis usually occurs during the perimenstrual and postpartum periods when very low levels of progesterone are observed. It is believed that a lack of neurosteroids in the body is one of the main causes of postpartum depression. Postpartum depression (PPD) is a form of depression which develops in women during the postnatal period. Clinical studies have been conducted, and the results indicate that Brexanolone (a water-soluble formulation of allopregnanolone) is effective in treating postpartum depression. Based on the evaluation of the HAMD-17 depression scale, women with PGD who received injectable neurosteroid doses achieved remission from postpartum depression more effectively and quickly than those in the placebo group. Subsequent studies were also conducted with the tablet form of neurosteroids (Zuranolone), and the results similarly showed favorable outcomes for postpartum depression. Additionally, during treatment with both injectable and tablet forms of neurosteroids, there were relatively few and non-threatening side effects for patients. This suggests that the benefits of neurosteroids in treating PPD may outweigh the potential harm and should possibly be considered and incorporated into the European psychiatric practice.
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