Neuroactive steroids and compositions thereof

A compound of Formula (I-4):

• or a pharmaceutically acceptable salt thereof, wherein
• Each of R2a, R2b, R4a, R4b, R6, R7, R11a, R11b, R15a, and R15b is independently hydrogen, halogen, cyano, hydroxyl, substituted or unsubstituted C1-6 alkyl, substituted or unsubstituted C2-6 alkenyl, substituted or unsubstituted C2-6 alkynyl, —ORD1, —OC(═O)RD1, —NH2, —N(RD1)2, —NRD1C(═O)RD1, a substituted or unsubstituted 3-6 membered monocyclic heterocycle, or a substituted or unsubstituted 8-12 membered bicyclic heterocycle wherein the monocyclic or bicyclic heterocycle has 1-3 heteroatoms independently selected from N, O, and S;
• Each RD1 is independently hydrogen, substituted or unsubstituted C1-6 alkyl, substituted or unsubstituted C2-6 alkenyl, substituted or unsubstituted C2-6 alkynyl, a substituted or unsubstituted 3-8 membered saturated, partially unsaturated, or fully unsaturated monocyclic ring having 0-3 heteroatoms independently selected from N, O, and S, an oxygen protecting group when attached to an oxygen atom, a nitrogen protecting group when attached to a nitrogen atom, or two RD1 groups are joined to form an substituted or unsubstituted 3-6 membered monocyclic heterocycle or 8-12 membered bicyclic heterocycle wherein the monocyclic or bicyclic heterocycle has 1-3 heteroatoms independently selected from N, O, and S;
• or
• any one of R2a and R2b, R4a and R4b, or R11a and R11b are joined together to form an oxo (═O) group;
• Each of R16 and R17 is independently hydrogen, halogen, cyano, hydroxyl, substituted or unsubstituted C1-6 alkyl, substituted or unsubstituted C2-6 alkenyl, substituted or unsubstituted C2-6 alkynyl, —ORA1, —SRA1, —N(RA1)2, —N(RA1), —CN(RA1)2, —C(O)RA1, —OC(═O)RA1, —OC(═O)ORA1, —OC(═O)SRA1, —OC(═O)N(RA1)2, —SC(═O)RA2, —SC(═O)ORA1, —SC(═O)SRA1, —NHC(═O)RA1, —SC(═O)N(RA1)2, —NHC(═O)ORA1, —NHC(═O)SRA1, —NHC(═O)N(RA1)2, —OS(═O)2RA2, —OS(═O)2ORA1, —S—S(═O)2RA2, —S—S(═O)2ORA1, —S(═O)RA2, —SO2RA2, —S(═O)2ORA1, or a substituted or unsubstituted 3-8 membered saturated, partially unsaturated, or fully unsaturated monocyclic ring having 0-3 heteroatoms independently selected from N, O, and S;
• Each RA1 is independently hydrogen, substituted or unsubstituted C1-6 alkyl, substituted or unsubstituted C2-6 alkenyl, substituted or unsubstituted C2-6 alkynyl, a substituted or unsubstituted 3-8 membered saturated, partially unsaturated, or fully unsaturated monocyclic ring having 0-3 heteroatoms independently selected from N, O, and S, an oxygen protecting group when attached to an oxygen atom, a sulfur protecting group when attached to a sulfur atom, a nitrogen protecting group when attached to a nitrogen atom, —SO2RA2, —C(O)RA2, or two RA1 groups are joined together to form a substituted or unsubstituted 3-6 membered saturated, partially unsaturated, or fully unsaturated monocyclic heterocycle having 1-3 heteroatoms independently selected from N, O, and S;
• Each RA2 is independently substituted or unsubstituted C1-6 alkyl, substituted or unsubstituted C2-6 alkenyl, substituted or unsubstituted C2-6 alkynyl, or a substituted or unsubstituted 3-8 membered saturated, partially unsaturated, or fully unsaturated monocyclic ring having 0-3 heteroatoms independently selected from N, O, and S;
• R3 is hydrogen, substituted or unsubstituted C1-6 alkyl, substituted or unsubstituted C2-6 alkenyl, substituted or unsubstituted C2-6 alkynyl, substituted or unsubstituted 3-8 membered saturated, partially unsaturated, or fully unsaturated monocyclic ring having 0-3 heteroatoms independently selected from N, O, and S;
• R5 is hydrogen, unsubstituted methyl, or absent;
• is a single bond or a double bond, provided that when is a single bond, R5 is hydrogen or methyl, and when is a double bond, R5 is absent;
• R19 is hydrogen or substituted or unsubstituted C1-6 alkyl;
• RX is hydrogen or substituted or unsubstituted C1-6 alkyl;
• RY is substituted or unsubstituted phenyl or a substituted or unsubstituted 3-6 membered monocyclic heteroaryl or 8-12 membered bicyclic heteroaryl wherein the monocyclic or bicyclic heteroaryl has 1-5 heteroatoms independently selected from N, O, and S;
• and
• t is 2 or 3.

A compound selected from:

• Compound No.
• Structure
• 69
• 70
• 71
• 72
• 73
• 74
• 75
• 76
• 77
• 78
• 79
• 81
• 82
• 83
• 84
• 85
• 86
• 87
• 88
• 89
• 90
• 91
• 92
• 93
• 94
• 95
• 98
• 99
• 100
• 101
• or a pharmaceutical acceptable salt thereof.

A compound of Formula (X)

• or a pharmaceutically acceptable salt thereof, wherein
• R2a is hydrogen or substituted or unsubstituted C1-6 alkyl;
• R3a is substituted or unsubstituted C1-6 alkyl or substituted or unsubstituted C1-6 alkyl-O—C1-6 alkyl;
• R19 is hydrogen or substituted or unsubstituted C1-6 alkyl;
• RY is a 3-8 membered saturated, partially unsaturated, or fully unsaturated monocyclic ring having 0-2 nitrogen atoms, wherein the 3-8 membered ring of R is optionally substituted with 1-3 groups independently selected from halogen, —CN, or C1-6 alkyl;
• and
• t is 1 or 2;
• provided that when t is 1, R3a is —CH2OCH2CH3, and RY is substituted or unsubstituted pyrazinyl, then R19 is —CH3.

A compound of Formula (XI)

• or a pharmaceutically acceptable salt thereof, wherein
• R1 is unsubstituted C1-3 alkyl;
• R19 is hydrogen or unsubstituted C1-3 alkyl;
• and
• Ring RY is
• wherein two of W1, W2, W3, W4, and W5 are —N═, and the remainder are —C(R′)═;
• and
• Each R′ is independently hydrogen or —CN, wherein at least one R′ is —CN.