Abstract
The hypothalamic-pituitary-adrenal axis (HPA) is the core stress axis in man, and together with the sympathoadrenal medullary system (SAM) it co-ordinates response to the diverse range of stressors, from psychological to physical. There is considerable interplay between both neuronal systems, especially between the noradrenergic nucleus locus coeruleus which provides central regulation of the SAM and the parvocellular neurones which regulate the HPA. The SAM by triggering catecholamine release provides the acute stress response, whilst the HPA governs longer term stress defence mechanisms. Together these systems regulate energy utilisation and metabolic activity throughout the body.
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References
Vale W, Spiess J, Rivierc et al (1981) Characterisation of a 41 residue ovine hypothalamic peptide that stimulates secretion of the corticotropin and beta-endorphin. Science 213: 1394–1399
Scott LV, Dinan TG (1998) Vasopressin and the regulation of hypothalamic-pituitaryadrenal axis function: Implications for the pathophysiology of depression. Life Sciences 62: 1985–1998
Axelrod J, Reisine TD (1984) Stress hormones: their interaction and regulation. Science 224: 452–459
Selye H (1956) The stress of life. McGraw-Hill, New York
McEwen BS, Davis PG, Parsons B (1979) The brain as a target for steroid hormone action. Ann Rev Neurosci 2: 65–112
Reul JMHM, DeKloet R (1986) Anatomical resolution of two types of corticosterone receptor sites in rat brain with in vitro autoradiography and computerised image analysis. JSteroid Biochem 24: 296–304
Dinan TD (1994) Glucocorticoids and the genesis of depressive illness: A psychobiological model. Brit JPsych 164: 365–371
Catalan R, Gallart JM, Castellanos JM, Galard R (1998) Plasma corticotropin-releasing factor in depressive disorders. Biol Psychiatry 44: 15–20
Nemeroff CB, Owens MJ, Bissette G et al (1984) Elevated concentrations of CSF corticotropin-releasing factor-like immunoreactivity in depressed patients. Science 226: 1342–1344
Geracioti TD, Orth DN, Ekhator NN (1992) Serial cerebrospinal fluid corticotropinreleasing hormone concentration in healthy and depressed humans. J Clin Endocrin Metab 74: 1325–1330
Halbreich U, Zumoff B, Kream J, Fukushima DK (1982) The mean 1300–1600 h plasma cortisol concentration as a diagnostic test for hypercortisolism. J Clin Endocrin Metab 54: 1262–1264
Galard R, Gallart JM, Catalan R et al (1991) Salivary cortisol levels and their correlation with plasma ACTH levels in depressed patients before and after the DST. Am JPsych 148: 505–508
De Bellis MD, Gold PW, Geracoti D, Listwak S, Kling MA (1993) Fluoxetine significantly reduces CFS CRH and AVP concentrations in patients with major depression. Am J Psych 150: 656–657
Nemeroff CB, Bissette G, Akil H, Fink M (1991) Neuropeptide concentrations in cerebrospinal fluid of depressed patients treated with electroconvulsive therapy: Corticotropin releasing factor, ß-endorphin and somatostadin. Brit J Psych 158: 59–63
O’Keane V, McLoughlin D, Dinan TD (1992) D-fenfluramine-induced prolactin/cortisol release in major depression: Response to treatment. J Affect Disorders 26: 143–150
Carroll BJ, Curtis GC, Davies BM et al (1976) Urinary free cortisol excretion in depression. Psychol Med 6: 43–51
Linkowski P, Mendelwicz J, Kerkhofs M et al (1987) 24 hour profiles of adrenocorticotropin, cortisol and growth hormone in major depression: effect antidepressant treatment. J Clin Endocrin Metab 65: 141–152
American Psychiatric Association Task Force (1987) The dexamethasone suppression test: An overview of its current state in Psychiatry. Am J Psych 144: 1253–1262
Carroll BJ (1982) The dexamethasone suppression test for melancholia. Brit J Psych 140: 292–304
Ribeiro SCM, Tandon R, Grunhaus L, Greden JF (1993) The DST as a predictor of outcome in depression: A meta-analysis. Am J Psych 150: 1618–1629
Carroll BJ (1968) Pituitary-adrenal function in depression. Lancet 1: 1373
Goldberg IK (1980) Dexamethasone suppression tests in depression and response to treatment. Lancet 2: 92
Greden JF, Albala AA, Haskett RF et al (1980) Normalisation of dexamethosone suppression test: A laboratory index of recovery from endogenous depression. Bio Psychiatry 15: 449–458
Holsboer F, Liebl R, Hofschuster E (1982) Repeated dexamethasone suppression tests during depressive illness. J Affective Dis 4: 93–101
Asnis GM, Halbreich U, Rabinowitz H et al (1986) The dexamethasone suppression test (1 mg and 2 mg) in major depression: illness versus recovery. J Clin Psychopharma 6: 294–296
Charles GA, Schittecatte M, Rush AJ et al (1989) Persistent cortisol nonsuppression after clinical recovery predicts symptomatic relapse in unipolar depression. J Affective Dis 17: 271–278
Holsboer F, Gerken A, Von Bardeleben U et al (1986) Human corticotropin-releasing hormone in depression. Biol Psychiatry 21: 609–611
Amsterdam JD, Maislin G, Winokur A, Kling M, Gold P (1987) Pituitary and adrenocorical responses to the ovine corticotropin-releasing hormone in depressed patients and healthy volunteers. Arch Gen Psychiatry 44: 775–781
Ur E, Dinan TG, O’Keane V et al (1992) Effect of metyrapone on the pituitary-adrenal axis and depression: Relation to dexamethasone suppressors status. Neuroendocrin 56: 533–539
Amsterdam JD, Maisling, Winokur et al (1988) The CRH stimulation test before and after clinical recovery from depression. J Affective Dis 14: 213–222
Vieta E, Gasto C, De Osaba MJM et al (1997) Prediction of depressive relapse in remitted bipolar patients using corticotropin-releasing hormone challenge test. ACTA Psychiatrica Scandinavica 95: 205–211
Holsboer FH (1995) Neuroendocrinology of mood disorders. In: FE Bloom, DJ Kuffer (eds): Psychopharmacology: The Fourth Generation of Progress. Raven Press, New York 957–970
Heuser I, Yassouridisa, Holsboer F (1994) The combined dexamethasone: A refined laboratory test for psychiatric disorders. J Psychiatric Res 28: 341–356
Heuser IJE, Schweiger U, Gotthard DT et al (1996) Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects. Am J Psych 153: 93–99
Holsboer-Trachsler E, Stohler R, Hatzinger M (1991) Repeated administration of the combined dexamethasone-human corticotropin releasinghormone stimulation test during treatment of depression. Psychiat Res 38: 163–171
Dinan TG (1997) Serotonin and the regulation of hypothalamic-pituitary-adrenal axis function. Life Sciences 58: 1683–1693
Lesch KP (1991) 5-HT1A receptor responsivity in anxiety disorders and depression. Progress Neuropsychopharma Bio Psychiatry 15: 723–733
Lesch KP, Hoh A, Schulte HM (1991) Long term fluoxetine treatment decreases 5-HT 1A receptor responsivity in obsessive-compulsive disorder. Psychopharmacology 105: 415–420
Thakore JH, Barnes C, Joyce J, Dinan TG (1997) The effects of antidepressant treatment on corticotropin-induced cortisol responses in patients with melancholic depression. Psychiatry Res 73: 27–32
O’Toole SM, Seckula LK, Rubin RT (1997) Pituitary-adrenal cortical axis measures as predictors of sustained remission in major depression. Biol Psychiatry 42: 85–89
Rubin RT, Phillips JJ, Sadow TF, McCracken JT (1995) Adrenal gland volume in major depression: Increased during the depressive episode and decreased with successful treatment. Arch Gen Psychiatry 52: 213–218
Kitayama I, Janson AM, Cintra A (1988) Effects of chronic imipramine treatment on glucocorticoid receptor immunoreactivity in various regions of the rat brain. J Neural Trans 73: 191–203
Brady LS, Whitfield HJ, Fox R (1991) Longterm antidepressant administration alters corticotropin-releasing hormone, tyrosine hydroxylase and mineralcorticoid receptor gene expression in the rat. J Clin Investig 87: 831–837
Holsboer R, Barden N (1996) Antidepressants and hypothalamic-pituitary-adrenocortical regulation. Endocr Rev 17: 187–199
Murphy BE (1997) Antiglucocorticoid therapies in major depression: a review. Psychoneuroendocrinol 22: S125–145
Thakore JH, Dinan TG (1995) Cortisol synthesis inhibition: a new strategy for the clinical and endocrine manifestations of depression. Biol Psychiat 37: 364–368
O’Dwyer AM, Lightman SL, Marks MN, Checkley S (1995) Treatment of major depression with metyrapone and hydrocortisone. J Affect Dis 33: 123–128
Wolkowitz OM, Reus VI, Manfredi F (1993) Ketoconazonazole administration in hypercortisolemic depression. Am J Psych 150: 810–812
Amsterdam SD, Hornig-Rohan M (1993) Adrenocortical activation and steroid suppression with ketoconazole in refractory depression. Biol Psychiat 33: 88A
Dinan TG, Lavelle E, Scott LV, Newell-Price J, Grossman A (1999) Desmopressin normalises the blunted ACTH response to corticotropin releasing hormone in melancholic depression: evidence of enhanced vasopressinergic responsivity. J Clinendocrinol Metab 84: 2238–2246
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Dinan, T.G. (2001). The hypothalamic-pituitary-adrenal axis and antidepressant action. In: Leonard, B.E. (eds) Antidepressants. Milestones in Drug Therapy MDT. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-8344-3_6
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DOI: https://doi.org/10.1007/978-3-0348-8344-3_6
Publisher Name: Birkhäuser, Basel
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