Future therapeutic targets in mood disorders:
the glucocorticoid receptor
by
McQuade R, Young AH
The Stanley European Bipolar Research Centre,
Psychiatry Research Laboratory,
The Medical School,
Newcastle upon Tyne, UK
Br J Psychiatry 2000 Nov;177(5):390-395

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.

CRF
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HPA Axis
Astressin
Metyrapone
Ketoconazole
Cortisol blues
Corticosteroids
Mineralocorticoids
Pharmacogenetics
Cushing's Syndrome
CRH1 receptor antagonists
The glucocorticoid receptor
Glucocorticoids and antidepressants
The corticosteroid hypothesis of depression
Stress, dynorphin, dysphoria and the kappa opioid system

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