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Hypothalamic-pituitary-adrenal axis and bipolar disorder

Lookup NU author(s): Dr Paul Mackin, Professor Allan Young


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There is robust evidence demonstrating abnormalities of the HPA axis in bipolar disorder. Hypercortisolism may be central to the pathogenesis of depressive symptoms and cognitive deficits, which may in turn result from neurocytotoxic effects of raised cortisol levels. Manic episodes may be preceded by increased ACTH and cortisol levels, leading to cognitive problems and functional impairments. Identification and effective treatment of mood and cognitive symptoms of mood disorders are clinical goals, but currently available treatments may fall short of this ideal. Manipulation of the HPA axis has been shown to have therapeutic effects in preclinical and clinical studies, and recent data suggest that direct antagonism of GRs may be a future therapeutic strategy in the treatment of mood disorders. © 2005 Elsevier Inc. All rights reserved.

Publication metadata

Author(s): Daban C, Vieta E, Mackin P, Young AH

Publication type: Review

Publication status: Published

Journal: Psychiatric Clinics of North America

Year: 2005

Volume: 28

Issue: 2

Pages: 469-480

Print publication date: 01/04/2005

ISSN (print): 0193-953X

ISSN (electronic): 1558-3147


DOI: 10.1016/j.psc.2005.01.005

PubMed id: 15826743