The pharmacological actions of benzodiazepines at the GABA A receptor are similar to those of neurosteroids . Neuroactive steroids are positive allosteric modulators of the GABA A receptor, enhancing GABA function and in turn have effects on mood and other functions. Many benzodiazepines ( diazepam , medazepam , estazolam , temazepam , flunitrazepam and nitrazepam) potently inhibit the enzymes involved in the metabolism of neurosteroids. The tetrahydroxazole ring that cloxazolam and oxazolam have decreases the inhibitory potency of benzodiazepines on neurosteroids. Thus there could be subtle differences between cloxazolam and other benzodiazepines.  However, because the parent prodrugs of cloxazolam and oxazolam were tested rather than the active metabolites, this is purely speculative.
While steroids from the periphery have profound effects on the nervous system, the nervous system also produces its own steroids de novo (“neurosteroids”). The physiological importance of neurosteroids is beginning to be understood. These steroids potentially have roles in sedative/hypnotic behavior, anxiety, learning, and memory. At the cellular level, neurosteroids affect neuronal excitability, synaptic plasticity and cell proliferation and survival. Early findings hold promise for future strategies to treat specific psychologicalconditions and neurological diseases. This Brief will focus on the current state of understanding of brainderived neurosteroids.
Margaret Kemeny, PhD - psychoneuroimmunology; relationship between psychological factors, neurophysiological mechanisms and disease processes, particularly in HIV-1 and inflammatory diseases; effects of cognitive representations on emotion, physiology and health; threats to social status and their effects on cognitive representations of the self and self-conscious emotions including shame, as well as the hypothalamic pituitary adrenal axis and the cytokine network, particularly pro-inflammatory cytokines and cognitive representations of future health and their physiological correlates and health consequences; the role of expectancies in the effects of placebos on inflammatory processes