title: Glucocorticoids as predictors of treatment response in depression.
abstract: BACKGROUND
  Glucocorticoids and the stress hormone system have been implicated in the pathophysiology of depression and in the mechanism of action of antidepressant response. Many studies have investigated this system in an effort to predict response to antidepressant treatment. The purpose of this review is to evaluate the evidence for using glucocorticoid-related measures for personalized treatment of depression.
  
  
  METHODS
  We conducted a MEDLINE search from 1966 through 2010 and examined English-language studies reporting on the use of endocrine challenge tests and genetic polymorphisms in genes regulating the stress hormone system as predictors of antidepressant response.
  
  
  RESULTS
  While measures of glucocorticoid levels using endocrine tests, as well polymorphisms in genes regulating the stress hormone system, show associations with response to antidepressant treatment, these measures will need to be combined with other variables, including clinical information and other biological measures, to realize the goal of highly predictive and clinically relevant biomarkers.
  
  
  CONCLUSIONS
  The glucocorticoid system is potentially of great use in predicting antidepressant response. New combinations of biomarkers including these measures should be tested to develop clinically relevant predictors.
authors.affiliation: Max Planck Institute of Psychiatry-RG Molecular Genetics of Affective Disorders, Munich, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Horstmann
authors.forename: Elisabeth B
authors.initials: EB
authors.lastname: Binder
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000235:genetics; D005938:Glucocorticoids / Q000097:blood*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D010597:Pharmacogenetics; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011110:Polymorphism, Genetic / Q000235:genetics; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D015415:Biomarkers; D005938:Glucocorticoids