Risk Factors for Development of Depression and Psychosis Glucocorticoid Receptors and Pituitary Implications for Treatment with Antidepressant and Glucocorticoids

Research output: Chapter in Book/Report/Conference proceedingConference paper

160 Citations (Scopus)

Abstract

Increased levels of glucocorticoid hormones-the main product of the hypothalamic-pituitary-adrenal (HPA) axis-have been considered to be "depressogenic," but this notion has largely derived from studies in patients with endocrine conditions, such as Cushing's syndrome or exogenous treatment with synthetic glucocorticoids. In these conditions, it is likely that the full impact of the high glucocorticoid levels is felt on the brain, through over-stimulation of the glucocorticoid receptors (GRs); indeed, normalizing these high levels leads to an improvement of mood in these patients. However, a completely different mechanism may be operating in major depression, where the increased levels of glucocorticoid hormones are conceptualized as driven by an impairment in GR function (glucocorticoid resistance), and therefore as a "compensatory" mechanism. Moreover, clinical and experimental studies have shown that antidepressants increase GR function, thus leading to resolution of glucocorticoid resistance. Interestingly, a number of studies have also demonstrated that manipulating GR function with both agonists and antagonists has an antidepressant effect, and indeed that other drugs targeting the HPA axis and cortisol secretion-even drugs with opposite effects on the HPA axis-have antidepressant effects. These studies do not support the notion that "high levels of glucocorticoids" always have a depressogenic effect, nor that decreasing the effects of these hormones always has an antidepressant effects.
Original languageEnglish
Title of host publicationUnknown
Place of PublicationOXFORD
PublisherBlackwell Publishing
Pages144 - 152
Number of pages9
Volume1179
ISBN (Print)978-1-57331-748-1
DOIs
Publication statusPublished - 2009
EventConference on Glucocorticoids and Mood - Clinical Manifestations, Risk Factors and Molecular Mechanisms - San Diego, CA
Duration: 20 Jun 200821 Jun 2008

Publication series

NameGLUCOCORTICOIDS AND MOOD CLINICAL MANIFESTATIONS, RISK FACTORS, AND MOLECULAR MECHANISMS

Conference

ConferenceConference on Glucocorticoids and Mood - Clinical Manifestations, Risk Factors and Molecular Mechanisms
CitySan Diego, CA
Period20/06/200821/06/2008

Fingerprint

Dive into the research topics of 'Risk Factors for Development of Depression and Psychosis Glucocorticoid Receptors and Pituitary Implications for Treatment with Antidepressant and Glucocorticoids'. Together they form a unique fingerprint.

Cite this