Expanding the Therapeutic Potential of Neuroactive Steroids: A Promising Strategy for Hyperdopaminergic Behavioral Phenotypes

Neuro(active)steroids, particularly those in the 5α reductase pathway, play a significant role in modulating dopamine activity, which is crucial in the pathophysiology of neuropsychiatric disorders such as addiction, ADHD, schizophrenia, impulse control disorders, and Parkinson's Disease. This review emphasizes the neuromodulatory effects of neuro(active)steroids like pregnenolone, progesterone, and allopregnanolone on dopamine signaling and their potential therapeutic benefits. It also explores pharmacological interventions targeting 5α reductase activity to address conditions with excessive dopaminergic activation, including psychotic phenotypes, motor complications, decision-making issues, and addiction.