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Revista de Neurologia May 2022Catamenial pattern epilepsy is defined as an increase in the frequency of seizures during a specific stage of the menstrual cycle compared to baseline. It has been... (Review)
Review
Catamenial pattern epilepsy is defined as an increase in the frequency of seizures during a specific stage of the menstrual cycle compared to baseline. It has been described that around a third of women with epilepsy have a catamenial pattern. The changes in the seizure pattern would be explained by the influence of catamenial fluctuations, of female gonadal hormones on neuronal excitability. Progesterone through its metabolite allopregnanolone plays a protective role by increasing GABAergic transmission; however, its effect on brain progesterone receptors can increase neuronal excitability. The effects of estrogens are complex, they tend to increase neuronal excitability, although their effects depend on their concentration and exposure time. Three catamenial patterns of seizure exacerbation have been proposed: the perimenstrual pattern, the periovulatory pattern, and the luteal pattern. The diagnostic approach is carried out through a systematic process of 4 steps: a) clinical history of the pattern of the menstrual cycle and epileptic seizures; b) diagnostic methods to characterize the menstrual cycle and the pattern of seizures; c) check diagnostic criteria; and d) categorize the catamenial pattern. The treatment options studied require a higher level of evidence, and there is no specific treatment. Optimization of conventional antiseizure treatment is recommended as the first therapeutic option. Other therapeutic options, such as non-hormonal and hormonal treatments, could be useful in case the first therapeutic option proves to be ineffective.
Topics: Epilepsy, Reflex; Female; Humans; Menstrual Cycle; Pregnanolone; Progesterone; Seizures
PubMed: 35484702
DOI: 10.33588/rn.7409.2022041 -
Clinical efficacy and safety of Zuranolone (SAGE-217) in individuals with major depressive disorder.Journal of Affective Disorders Nov 2023Major depressive disorder (MDD) is a common mental disorder with a high rate of morbidity and mortality. Dysfunctional signaling of gamma-aminobutyric acid (GABA) has... (Review)
Review
Major depressive disorder (MDD) is a common mental disorder with a high rate of morbidity and mortality. Dysfunctional signaling of gamma-aminobutyric acid (GABA) has been implicated in some studies in the etiology of MDD. Zuranolone (SAGE-217) is a novel, oral neuroactive steroid and an investigational positive allosteric modulator of synaptic and extrasynaptic GABAA receptors. Herein, we aimed to evaluate the efficacy and safety of Zuranolone in individuals with MDD. We reviewed seven studies including 1662 participants with MDD. Zuranolone was investigated as an oral, once-daily, 14-day treatment course. The results of our synthesis indicate that the antidepressant effects of Zuranolone are rapid, clinically meaningful, and replicated across multiple randomized clinical trials. In addition to replicated efficacy, Zuranolone is associated with an acceptable level of treatment-emergent adverse events and discontinuation without serious adverse events. It is believed that Zuranolone's antidepressant effects arise from its ability to enhance inhibitory GABAergic signaling by increasing synaptic and extrasynaptic GABAA activity and regulation of GABAA receptor expression. Taken together, preliminary evidence suggests the potential for antidepressant effects of Zuranolone. Zuranolone has been approved by FDA for postpartum depression, and is showing efficacy in major depressive disorder. Future research vistas should seek to determine the durability of this treatment approach as well as its effects on domain-specific outcomes (e.g., anhedonia, circadian rhythm, arousal systems) along with application in other diagnostic entities (e.g., bipolar depression).
Topics: Female; Humans; Depressive Disorder, Major; Pregnanes; Antidepressive Agents; Receptors, GABA-A; Treatment Outcome
PubMed: 37557991
DOI: 10.1016/j.jad.2023.08.027 -
Current Pharmaceutical Design 2016Guggulsterone [4, 17(20)-pregnadiene-3, 16-dione] is a plant sterol derived from the gum resin of the tree Commiphora wightii. The gum resin of the guggul tree has been... (Review)
Review
Guggulsterone [4, 17(20)-pregnadiene-3, 16-dione] is a plant sterol derived from the gum resin of the tree Commiphora wightii. The gum resin of the guggul tree has been used in traditional medicine for centuries to treat obesity, liver disorders, internal tumors, malignant sores, ulcers, urinary complaints, intestinal worms, leucoderma, sinus, edema and sudden paralytic seizures. Guggulsterone has been shown to modulate the nuclear receptors, farnesoid X receptor, pregnane X receptor, CYP 2b10 gene expression, and the bile salt export pump for cholesterol elimination. Recent research indicates that the active components of gum guggul, E- and Zguggulsterone have the potential to both prevent and treat cancers. Guggulsterone inhibits the growth of a wide variety of tumor cells and induces apoptosis through down regulation of antiapoptotic gene products (IAP1, xIAP, Bfl-1/A1, Bcl-2, cFLIP, and survivin), modulation of cell cycle proteins (cyclin D1 and c-Myc), activation of caspases, inhibition of Akt, and activation of JNK. Guggulsterone modulates the expression of gene products involved in metastasis (MMP-9, COX-2, and VEGF) of tumor cells. Guggulsterone mediates gene expression through the modulation of several transcription factors, including NF-κB, STAT3, C/EBPα, androgen receptor, and glucocorticoid receptors. This review describes the anti-cancer properties, molecular targets, and the apoptotic effects of guggulsterone.
Topics: Animals; Antineoplastic Agents; Apoptosis; Cell Line, Tumor; Cell Proliferation; Commiphora; Humans; Molecular Structure; Neoplasms; Neovascularization, Pathologic; Plant Gums; Pregnenediones; Resins, Plant; Xenograft Model Antitumor Assays
PubMed: 26561056
DOI: 10.2174/1381612822666151112153117 -
The American Journal of Geriatric... Jun 2020
Topics: Drug Therapy, Combination; Humans; Megestrol; Megestrol Acetate; Mental Disorders
PubMed: 32122805
DOI: 10.1016/j.jagp.2020.01.188 -
Molecules (Basel, Switzerland) Aug 2022For our interest in the potential biologically active and structurally unique steroidal glycosides, continued phytochemical investigation of was carried out; twelve new...
For our interest in the potential biologically active and structurally unique steroidal glycosides, continued phytochemical investigation of was carried out; twelve new seco-pregnane glycosides, cynataihosides I-L (-), M-T (-), and two known glycosides, glaucoside A () and atratcynoside F (), were isolated from the 95% ethanol extract of . Two new aglycones were found among compounds , , , and . The structures of the glycosides were elucidated based on 1D and 2D NMR spectroscopic data, HR-ESI-MS analysis, and chemical evidence. The cytotoxicity of compounds against three human tumor cell lines (HL60, THP-1, and PC-3) were evaluated by MTT assay. Compound displayed significant cytotoxicity against THP-1 and PC-3 cell line with IC values of 5.08 and 22.75 μm, respectively. Compounds and exhibited moderate and selective cytotoxicity on HL60 and THP-1 with IC values of 17.78 and 16.02 μm, respectively.
Topics: Cynanchum; Glycosides; Humans; Molecular Structure; Plant Roots; Pregnanes
PubMed: 36080268
DOI: 10.3390/molecules27175500 -
Obstetrics and Gynecology Clinics of... Mar 2023Specifically, meta-analyses of randomized trials demonstrate that vaginal progesterone reduces the risk of preterm birth in selected high-risk singleton pregnancies.... (Review)
Review
Specifically, meta-analyses of randomized trials demonstrate that vaginal progesterone reduces the risk of preterm birth in selected high-risk singleton pregnancies. 17-OHPC may also reduce the risk of recurrent preterm birth in singletons. Finally, one trial suggests that vaginal progesterone may also be beneficial in improving live birth rates in singletons with prior miscarriages and early pregnancy bleeding.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Progesterone; 17 alpha-Hydroxyprogesterone Caproate; Progestins; Hydroxyprogesterones; Premature Birth
PubMed: 36822696
DOI: 10.1016/j.ogc.2022.10.004 -
Drugs May 2019Brexanolone (ZULRESSO™) is an intravenously administered, small molecule, neuroactive steroid GABA receptor positive allosteric modulator that was developed by Sage...
Brexanolone (ZULRESSO™) is an intravenously administered, small molecule, neuroactive steroid GABA receptor positive allosteric modulator that was developed by Sage Therapeutics under license to the University of California for the treatment of postpartum depression (PPD). The formulation is a mixture of allopregnanolone, an endogenous inhibitory pregnane neurosteroid, and sulfobutylether-beta-cyclodextrin (a solubilizing agent). In mid-March 2019 brexanolone received its first global approval in the USA for the treatment of PPD in adult women. This article summarizes the milestones in the development of brexanolone leading to its first approval for the treatment of adult women with PPD.
Topics: Administration, Intravenous; Adolescent; Adult; Allosteric Regulation; Depression, Postpartum; Drug Approval; Drug Combinations; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Pregnanolone; Receptors, Steroid; Treatment Outcome; United States; United States Food and Drug Administration; beta-Cyclodextrins
PubMed: 31006078
DOI: 10.1007/s40265-019-01121-0 -
Developments in Ophthalmology 2016Steroids have been extensively used to treat macular edema due to diabetic retinopathy, venous occlusive disease, ocular inflammation and, to a lesser extent, also in... (Review)
Review
Steroids have been extensively used to treat macular edema due to diabetic retinopathy, venous occlusive disease, ocular inflammation and, to a lesser extent, also in some cases of choroidal neovascularization. The various intraocular steroids that have been employed include dexamethasone, triamcinolone and fluocinolone. During the past few years, new drug delivery methods for corticosteroids have been developed and are now part of our therapeutic armamentarium. This chapter provides a brief description of the pharmacology, efficacy and adverse effects associated with the use of steroids in various retinal diseases.
Topics: Dexamethasone; Drug Delivery Systems; Fluocinolone Acetonide; Glucocorticoids; Humans; Macular Edema; Triamcinolone
PubMed: 26502207
DOI: 10.1159/000431198 -
Journal of Oral and Maxillofacial... Jun 2018
Topics: Dexamethasone; Humans; Methylprednisolone; Molar, Third; Postoperative Period
PubMed: 29596795
DOI: 10.1016/j.joms.2018.03.001 -
Lakartidningen Jan 2021
Topics: Betamethasone; Dexamethasone; Glucocorticoids; Humans; Research
PubMed: 33417235
DOI: No ID Found