Future therapeutic targets in mood disorders: the glucocorticoid receptor.
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.


OBJECTIVE
To review the evidence for the involvement of the glucocorticoid receptor in the pathogenesis and treatment of mood disorders.


METHODS
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.
McQuade
R
R
The Stanley European Bipolar Research Centre, Psychiatry Research Laboratory, The Medical School, Newcastle upon Tyne, UK.
Young
A H
AH
D000928:Antidepressive Agents / Q000494:pharmacology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D019964:Mood Disorders / Q000188:drug therapy* / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011965:Receptors, Glucocorticoid / Q000187:drug effects* / Q000502:physiology; D015854:Up-Regulation / Q000187:drug effects
D000928:Antidepressive Agents; D011965:Receptors, Glucocorticoid