R McQuade1, A H Young. 1. The Stanley European Bipolar Research Centre, Psychiatry Research Laboratory, The Medical School, Newcastle upon Tyne, UK.
Abstract
BACKGROUND: The hypercortisolaemia and dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis associated with mood disorders have been attributed to a breakdown in the glucocorticoid-receptor-mediated negative feedback mechanism regulating HPA activity. Reinstating normal feedback may be therapeutic in mood disorders. AIMS: To review the evidence for the involvement of the glucocorticoid receptor in the pathogenesis and treatment of mood disorders. METHOD: Medline and hand searches were carried out, selecting literature relevant to psychiatrists and psychopharmacologists. RESULTS: A dysfunction in glucocorticoid receptors is integral to the HPA abnormalities of mood disorders. Antidepressant and mood-stabilising drugs can up-regulate glucocorticoid receptors, restoring glucocorticoid function. Preliminary clinical studies targeting the glucocorticoid receptor are encouraging. CONCLUSIONS: Drugs designed specifically to up-regulate glucocorticoid receptors may be integral to future strategies in treating mood disorders.
BACKGROUND: The hypercortisolaemia and dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis associated with mood disorders have been attributed to a breakdown in the glucocorticoid-receptor-mediated negative feedback mechanism regulating HPA activity. Reinstating normal feedback may be therapeutic in mood disorders. AIMS: To review the evidence for the involvement of the glucocorticoid receptor in the pathogenesis and treatment of mood disorders. METHOD: Medline and hand searches were carried out, selecting literature relevant to psychiatrists and psychopharmacologists. RESULTS:A dysfunction in glucocorticoid receptors is integral to the HPA abnormalities of mood disorders. Antidepressant and mood-stabilising drugs can up-regulate glucocorticoid receptors, restoring glucocorticoid function. Preliminary clinical studies targeting the glucocorticoid receptor are encouraging. CONCLUSIONS: Drugs designed specifically to up-regulate glucocorticoid receptors may be integral to future strategies in treating mood disorders.
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