Progesterone, Neurosteroids, and the Hormonal Basis of Catamenial Epilepsy

The document from 2003 discusses the significance of progesterone and neurosteroids like allopregnanolone in managing catamenial epilepsy, which is linked to the menstrual cycle. It highlights that progesterone's ability to enhance GABA receptor activation may help control seizures. A case report within the document illustrates that the conversion of progesterone to its active metabolite is crucial for its therapeutic effect, as evidenced by a woman with catamenial epilepsy who experienced worsened seizures after taking finasteride, a drug that blocks this conversion. This case underlines the potential of neurosteroid-based therapies for epilepsy. However, the document also points out the limitations of progesterone treatment, such as hormonal side effects and a short serum half-life, suggesting that analogs of neurosteroids with better pharmacokinetic profiles might be more effective.