The glucocorticoid receptor: part of the solution or part of the problem?
Abstract
Clinical studies have demonstrated hyperactivity of the hypothalamic–pituitary–adrenal (HPA) axis and increased levels of cortisol in patients with major depression, because of an impairment of glucocorticoid receptor (GR)-mediated negative feedback (glucocorticoid resistance). Moreover, clinical and experimental studies have shown that antidepressants increase GR function, thus leading to resolution of glucocorticoid resistance. Interestingly, a number of studies have also demonstrated that manipulating GR function with both agonists and antagonists has an antidepressant effect, and indeed that other drugs targeting the HPA axis and cortisol secretion – even drugs with opposite effects on the HPA axis – have antidepressant effects. These studies do not support the notion that cortisol has ‘negative’ effects on the brain. On the contrary, this paper concludes that a lack of the ‘positive’ effects of cortisol on the brain, because of glucocorticoid resistance, is likely to be involved in the pathogenesis of depression.
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Successful antidepressant treatment is associated with resolution of impaired glucocorticoid negative feedback on the HPA axis.
“Successful antidepressant treatment is associated with resolution of the impairment in the negative feedback on the HPA axis by glucocorticoids.47”
From Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function (2014) · cites this paper as [47]
Normalization of GR function by antidepressant treatment is a significant predictor of long-term clinical outcome.
“Normalization of GR function by antidepressant treatment is a significant predictor of long-term clinical outcome.47”
From Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function (2014) · cites this paper as [47]
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- Authors
- Pariante, C. M.
- Affiliations
- King's College London (GB)
- Corresponding author
- Pariante, Carmine M.
- ORCID
- Pariante, Carmine M.
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2006-07
- Volume
- 20
- Issue
- 4_suppl
- Pages
- 79-84
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- OpenAlex
- W1980374662
- Cited by
- 192
- References
- 11
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 7 · 2020: 10 · 2019: 11 · 2018: 8 · 2017: 13 · 2016: 13 · 2015: 13 · 2014: 14 · 2013: 6 · 2012: 16
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- Wellcome Trust
- Medical Research Council
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- glucocorticoid receptor, major depressive disorder, hypothalamic-pituitary-adrenal axis, glucocorticoid resistance, cortisol, negative feedback, antidepressants, glucocorticoid receptor agonists, glucocorticoid receptor antagonist, depression pathogenesis
- MeSH terms
- Animals, Antidepressive Agents, Clinical Trials as Topic, Depression, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Receptors, Glucocorticoid
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