PREGNENOLONE

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Abstract
A review of the chemical properties, toxicity, pharmacology and hormonal relations of A5-pregnene-3/?-ol-20 one, and a tentative appraisal of its use in the treatment of oligospermia, fatigue, myasthenia gravis and arthritis. The compound is nominally related to progesterone but exhibits neither progestational, estrogenic, androgenic nor (probably) adreno-cortical actions to significant degree. It is non-toxic by all available criteria. In animals a "gonadotropic" and "testis-pro-tecting'' activity have been deduced, but the former is of lower grade than shown by testosterone, and has not led to clinical benefit in oligospermia. Excretion of 17-ketosteroids is reduced by pregnenolone under some conditions in man, but this is attended by inconstant effects on resistance to fatigue, conduct of strenuous effort, etc. (said to be accompanied by increased 17-ketosteroids in urine). The treatment of several hundred patients with rheumatoid arthritis inter alia using pregnenolone has led to a perplexing variety of results, from none whatever to striking remissions. Sedimentation rate and blood chemical detns. are generally unchanged, blood eosinophil counts have been reported elevated (over long intervals), and there have been irregular increases in urinary pregnandiol, following intramusc. admn. of 300 mg. daily; there were no recognizable side actions. Up to 600 mg. daily has been given. Interpretation of conflicting results and detn. of proper therapeutic role await continuing study.
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