This paper was presented at the Joint CINP/ASPR meeting, held in Brisbane, December 2005.
Antiglucocoticoid treatments for depression
Version of Record online: 9 MAY 2006
Australian and New Zealand Journal of Psychiatry
Volume 40, Issue 5, pages 402–405, May 2006
How to Cite
Young, A. H. (2006), Antiglucocoticoid treatments for depression. Australian and New Zealand Journal of Psychiatry, 40: 402–405. doi: 10.1111/j.1440-1614.2006.01813.x
- Issue online: 9 MAY 2006
- Version of Record online: 9 MAY 2006
- Received 30 November 2005; accepted 11 December 2005.
Objective: To selectively review the literature germane to antiglucocoticoid treatments for depression.
Method: Selective review of the relevant literature.
Results: Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis has been well-described in both bipolar and unipolar depression. Hypercortisolaemia, possibly secondary to breakdown in glucocorticoid-receptor-mediated negative feedback mechanisms within the HPA axis, may be central to the pathogenesis of both depressive symptoms and the neurocognitive deficits which characterize these disorders. Strategies to counteract the effects of elevated cortisol, which may potentially restore HPA axis integrity, have been the focus of recent research.
Conclusions: Both preclinical and clinical studies report encouraging results which suggest that lowering circulating cortisol levels or blocking the effects of elevated cortisol with antagonists, which may up-regulate glucocorticoid receptors, has therapeutic benefits in terms of improvements in depressive symptoms and some domains of neurocognitive function.