Neuroactive steroids and the pathophysiology of PTSD: Biomarkers for treatment targeting

Post-traumatic stress disorder (PTSD) is one of the most disabling psychiatric conditions. People who suffer from it often relive the trauma through nightmares, flashbacks, and constant hypervigilance. Recent research has highlighted the role of neurosteroids, especially allopregnanolone and pregnanolone, which strengthen the action of GABA—the brain’s main natural “brake.” In PTSD patients, these compounds are often reduced, leaving the brain more vulnerable and unable to switch off fear memories. Studies in humans and animals show that restoring neurosteroid levels can lower anxiety and over-arousal, support the “extinction” of traumatic memories, and even promote regeneration of nerve tissue. These findings open new opportunities: from targeted therapies to synthetic analogs that help restore the balance between brain excitation and inhibition. In the future, measuring neurosteroid levels could become a routine test to personalize treatment and reduce relapses, making PTSD a more manageable condition.