Glucocorticoids as Predictors of Treatment Response in Depression : Harvard Review of Psychiatry

Journal Logo

Advanced Search
REVIEW

Glucocorticoids as Predictors of Treatment Response in Depression

Horstmann, Sonja MD1; Binder, Elisabeth B. MD, PhD1

Author Information

1From the Max Planck Institute of Psychiatry—RG Molecular Genetics of Affective Disorders, Munich, Germany.

Correspondence: Elisabeth B. Binder, MD, PhD, Max Planck Institute of Psychiatry—RG Molecular Genetics of Depression, Kraepelinstr. 2–10, Munich 80804, Germany.E-mail:[email protected]

Original manuscript received September 23, 2010, accepted for publication November 18, 2010, revised manuscript received December 21, 2010, Original manuscript received March 23, 2011.

Declaration of interest: Dr. Binder has received grants from the National Institute of Mental Health, the National Alliance for Research on Schizophrenia and Depression, the Doris Duke Foundation, and Pfizer. Dr. Binder is coinventor on two pending patent applications: “FKBP5: a novel target for antidepressant therapy” (International Publication no. WO 2005/054500) and “Polymorphisms in ABCB 1 associated with a lack of clinical response to medicaments” (International Application no. PCT/EP2005/005194).

Harvard Review of Psychiatry 19(3):p 125-143, June 6, 2011. | DOI: 10.3109/10673229.2011.586550

Abstract

Introduction: 

Glucocorticoids and the stress hormone system have been implicated in the pathophysiology of depression and in the mechanism of action of antidepressant response. Many studies have investigated this system in an effort to predict response to antidepressant treatment. The purpose of this review is to evaluate the evidence for using glucocorticoid-related measures for personalized treatment of depression.

Methods: 

We conducted a MEDLINE search from 1966 through 2010 and examined English-language studies reporting on the use of endocrine challenge tests and genetic polymorphisms in genes regulating the stress hormone system as predictors of antidepressant response.

Results: 

While measures of glucocorticoid levels using endocrine tests, as well polymorphisms in genes regulating the stress hormone system, show associations with response to antidepressant treatment, these measures will need to be combined with other variables, including clinical information and other biological measures, to realize the goal of highly predictive and clinically relevant biomarkers.

Discussion: 

The glucocorticoid system is potentially of great use in predicting antidepressant response. New combinations of biomarkers including these measures should be tested to develop clinically relevant predictors.

© 2011 President and Fellows of Harvard College

Full Text Access for Subscribers:

Not a Subscriber?

Buy
Request Permissions

You can read the full text of this article if you:

Access through Ovid