How promising is neuroactive steroid drug discovery?

Current available pharmacological treatment of severe mental disorders is disappointing. The lack of real innovations beyond the established monoaminergic model led to the scarce development of drugs working on alternative pathways. Moreover, effectiveness of currently available drugs is good only in selected subgroups of patients [1,2], and side effects of these drugs negatively impact on compliance to treatment, besides poor insight into the necessity of long-term therapy [3,4]. Poor knowledge of the neurobiological basis of the categorically defined disorders, lack of reliable, biological markers of the psychometrically defined phenotypes, and the difficulties in devising valid animal models of psychopathologies lead some pharmaceutical companies to reallocate elsewhere part of their budgets. There is the need of new avenues in drug discovery that might be informative as far as the neurobiological pathways involved in the pathophysiology of mental disorders are concerned and promising with respect to potential effectiveness on new targets than those explored so far. This editorial explores a promising area of research: the investigation of neuroactive steroids (NASs).