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PHARMACOLOGICAL MODULATION OF HPA AXIS IN DEPRESSION – NEW AVENUES FOR POTENTIAL THERAPEUTIC BENEFITS

Nadja P. Maric orcid.org/0000-0002-7051-853X ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia, Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
Miroslav Adzic ; Laboratory of Molecular Biology and Endocrinology, VINCA Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia

Sažetak

One of the most consistent biological findings in major depression (MDD) is the altered activity of the hypothalamic-pituitaryadrenal
(HPA) axis. It is not surprising that glucocorticoid receptor (GR), the common mechanism for stress-related changes in
brain function, is a potential target of antidepressant drugs and therapies. All effective antidepressant treatments should trigger and
maintain GR-related cellular processes necessary for recovery from MDD. Classic antidepressants act indirectly, by affecting the
dynamic interplay between serotonin neurotransmission and HPA. On the other hand, certain compounds acting at suprahypothalamic,
HPA axis, glucocorticoid receptors, and post-receptor levels are being considered as new therapeutic options with the
potential to modulate the aforementioned system in affective disorders directly.
Different classes of drugs pharmacologically modify the HPA axis. This article summarizes the efficacy of classic antidepressants,
as well as drugs classified as "antiglucocorticoids" (GR agonists, GR antagonists, dehydroepiandrosterone- DHEA,
steroid synthesis inhibitors drugs, etc) in their capacity to heal glucocorticoid-mediated damage in depression. New avenues
investigating the potential therapeutic benefits of antiglucocorticoids in affective disorders are at the proof-of-concept stage and
future developments in this area deserve the full attention of psychiatrists and neuroscientists, as the current pharmacological
treatment of MDD is far from perfect.

Ključne riječi

depression – HPA – glucocorticoid – antiglucocorticoid - antidepressant

Hrčak ID:

161211

URI

https://hrcak.srce.hr/161211

Datum izdavanja:

17.9.2013.

Posjeta: 1.474 *