The role of estrogen receptor β and nicotinic cholinergic receptors in postpartum depression

Postpartum depression (PPD) is a devastating disease occurring in approximately 20% of women. Women who suffer from PPD appear to be more sensitive to postpartum hormonal changes than women who do not experience this form of depression. Furthermore, women who quit smoking prior to or during pregnancy, and who develop PPD, are at an increased risk of smoking relapse. Unfortunately, the mechanistic relationship between the pathophysiology of PPD and smoking relapse is unknown. Here we review the roles of both estrogen receptor beta (ERβ) and cholinergic nicotinic receptors (nAChRs) in the pathogenesis of depression and propose a mechanistic rationale to explain the high rate of smoking relapse exhibited by women who develop PPD.

► Estrogen receptor β (ERβ) plays a critical role in mood and behavior. ► A relationship exists between postpartum depression and nicotine dependence. ► Estrogen/nicotine associations in neuroendocrine-mediated depression are reviewed. ► We present a model for nicotine and estrogen cross-talk in the hypothalamus.