Hormonal Treatments for Major Depressive Disorder: State of the Art
Jennifer B. Dwyer, Awais Aftab, Rajiv Radhakrishnan, Alik S. Widge, Carolyn I. Rodríguez, Linda L. Carpenter, Charles B. Nemeroff, William M. McDonald, Ned H. Kalin
Abstract
a In the HPA axis, the paraventricular nucleus of the hypothalamus (PVN) releases corticotropin-releasing factor (CRF) and, to a lesser extent, arginine-vasopressin (AVP). These factors stimulate the anterior pituitary to release adrenocorticotropic hormone (ACTH) into the peripheral circulation, which stimulates the adrenal glands to release glucocorticoids (e.g., cortisol). Glucocorticoids act on both glucocorticoid receptors and mineralocorticoid receptors. Negative feedback occurs at the level of the pituitary, the hypothalamus, and higher brain structures (e.g., cortex, hippocampus, and periventricular thalamus).