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The British Journal of Psychiatry (2000) 177: 390-395
© 2000 The Royal College of Psychiatrists

REVIEW ARTICLES

Future therapeutic targets in mood disorders: the glucocorticoid receptor

RICHARD McQUADE, DPhil, Senior Research Associate and ALLAN H. Y. YOUNG, MRCPsych, Professor of Psychiatry

The Stanley European Bipolar Research Centre, Psychiatry Research Laboratory, The Medical School, Newcastle upon Tyne, UK

Correspondence: Professor A. H. Young, The Stanley European Bipolar Research Centre, Psychiatry Research Laboratory, The Medical School, Framlington Place, Newcastle upon Tyne NE2 4H. Tel./fax: 0191222 8210; e-mail: a.h.young{at}ncl.ac.uk

Declaration of interest None.

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.

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

Method 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.




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