Limbic-hypothalamic-pituitary-adrenal axis
in depression: literature review
by
Twardowska K; Rybakowski J
Psychiatr Pol, 1996 Sep, 30:5, 741-55

ABSTRACT

A review of the literature has been presented concerning pathogenetic role of limbic-hypothalamic-pituitary-adrenal axis (LHPA) in depression and the therapeutic possibility obtained by influencing this axis. Increased cortisol concentration has until now been the best documented biochemical abnormality in depression. Pathological results of the Dexamethasone Suppression Test pointing to hyperactivity of LHPA axis are found in about half of depressive patients. According to most recent research, primary disturbance of LHPA axis concerns hypothalamus (excessive secretion of corticotropin releasing factory) and limbic system (insufficiency of glucocorticoid receptor). An association was found between disturbances of LHPA axis in depression and immune system abnormalities in this illness. Disturbances of serotonergic and noradrenergic neurotransmission in depression may also partially result from LHPA axis dysfunction. In recent years, the attempts have been made to use drugs acting on LHPA axis for therapeutic purposes in depression, such as ketoconazole, within the framework of antiglucocorticoid strategy. Influencing LHPA axis may underlie the mechanism of new antidepressant drug, tianeptine. Recently, it was found that classical tricyclic antidepressant drugs as well as electroconvulsive may also act on LHPA in regulatory way.

CRF
TCAs
Stress
HPA axis
Tianeptine
Metyrapone
Noradrenaline
Ketoconazole
Corticosteroids
Social rank theory
Glucocorticoids and mood
Serotonin, stress, and CRH
Suicide, serotonin and the HPA
Depression, opioids and the HPA
Glucocorticoids and antidepressants

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