2025/07/29 by David R. Rubinow · 1 voice
Neuroscience · Psychology · #Neuroendocrine regulation and behavior #Stress Responses and Cortisol
paper · doi:10.61373/bm025k.0089
openalex publication_date 2025/07/29 · openalex created_date 2025/10/10 · openalex updated_date 2026/05/21
This Genomic Press Interview explores Dr. David R. Rubinow's transformative contributions to reproductive psychiatry through his journey from a major in philosophy and history to becoming a leading researcher. Rubinow fundamentally changed how we understand mood disorders linked to hormonal changes by discovering that women with conditions like premenstrual dysphoric disorder (PMDD), postpartum depression, and perimenopausal depression have normal hormone levels but respond differently to hormonal fluctuations, a concept he termed “differential sensitivity.” This breakthrough shifted treatment approaches from attempting to normalize hormones to targeting the abnormal responses themselves. His research directly contributed to the development of brexanolone (Zulresso), the first FDA-approved medication specifically for postpartum depression, which works through novel neurosteroid mechanisms rather than traditional antidepressant pathways. After 27 years at the National Institutes of Health (NIH), where he served as National Institute of Mental Health (NIMH) Clinical Director and founding Chief of the Behavioral Endocrinology Branch, Rubinow joined UNC-Chapel Hill in 2006 as Chair of Psychiatry, a position he held until 2019. During his tenure, he founded the UNC Center for Women's Mood Disorders, established the nation's first peripartum inpatient unit and first NIH-sponsored fellowship in women's mood disorders, and led the department to consistently top-10 national rankings in NIH funding. A member of the National Academy of Medicine since 2012, Rubinow has authored over 400 scientific publications and served as president of both the Society of Biological Psychiatry and the American College of Neuropsychopharmacology. The interview reveals how serendipity shaped his career trajectory, from an unexpected fellowship with Bob Post to leadership positions while maintaining parallel passions for music and woodworking. His philosophy of “bringing the chisel when sent for the hammer” reflects the thoughtful approach that has characterized his research. Rubinow's work has validated the experiences of millions of women whose hormone-related mood symptoms were previously dismissed, establishing reproductive psychiatry as a legitimate subspecialty with evidence-based treatments.