CommentaryNew insights into the role of cortisol and the glucocorticoid receptor in severe depression
Section snippets
How might cortisol contribute to severe depression?
Cortisol has significant interactions with the neurotransmitters, neuropeptides, and brain circuits associated with depressive symptomology. There is evidence, for several brain regions, of multiple positive feedback loops that may override multiple homeostats working to maintain hypothalmic-pituitary-adrenal (HPA) axis and stress homeostasis more generally. These data provide a framework to consider the putative antidepressant mechanisms of action for mifepristone.
Medical consequences of hypercortisolemia associated with depression
Major depression is associated with an increase in mortality, independent of suicide, smoking, and other risk factors for poor health (Wulsin et al 1999). Furthermore, major depression appears to be an independent risk factor for the development of coronary heart disease and osteoporosis and alters the prognosis of these disorders as well as other medical disorders such as diabetes. Elevated cortisol may be a mediating factor in these relationships. Glucocorticoids exist at or near the center
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