Antiglucocorticoid drugs in the treatment of depression
by
Reus VI, Wolkowitz OM.
Department of Psychiatry,
Center on Neurobiology and Behavior,
University of California, San Francisco,
School of Medicine,
401 Parnassus Avenue,
Box F-0984, San Francisco,
CA 94143-0984, USA.
vir@itsa.ucsf.edu
Expert Opin Investig Drugs 2001 Oct;10(10):1789-1796


ABSTRACT

A confluence of evidence indicates that prolonged elevation in gluco-corticoid level may result in disturbances of mood and cognition. In Cushing's syndrome, hypersecretion of cortisol is associated with a high incidence of depression, impairment in memory and hippocampal atrophy. Pharmacological usage of glucocorticoids is similarly productive of mood change and memory deficit. In patients with endogenous depression, hypercortisolaemia is associated with cognitive dysfunction and possibly a decrease in hippocampal volume. In each of these conditions, reduction of glucocorticoid level, either through discontinuation of steroid treatment or through usage of agents that block glucocorticoid synthesis, ameliorates the adverse behavioural effects. Traditional antidepressant agents may, in addition, stabilise mood through actions on the hypothalamic-pituitary adrenocortical (HPA) system. Although clinical usage of the currently available antiglucocorticoid drugs is limited by significant adverse side effect profiles, development of drugs specifically targeting the glucocorticoid receptor may lead to innovative strategies in the treatment of mood disorders.
CRF
LHPA
Stress
HPA Axis
Astressin
Metyrapone
Ketoconazole
Cortisol blues
Corticosteroids
Mineralocorticoids
Pharmacogenetics
Cushing's Syndrome
CRH1 receptor antagonists
Stress, depression and anxiety
The corticosteroid hypothesis of depression
Glucocorticoid receptors and mood disorders
Stress, glucocorticoid receptor loss and depression
Stress, dynorphin, dysphoria and the kappa opioid system

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