ADRENAL-FUNCTION IN MAJOR DEPRESSION

The adrenal gland consists of two morphologically and functionally distinct tissues, the medulla and the cortex. There is evidence for sympathoadrenal hyperactivity in many patients with major depression and literally hundreds of reports documenting hypothalamic-pituitary adrenal (HPA) axis hyperactivity in drug free depressed patients. This ''endocrinopathy'' has been shown to be associated with alterations in the adrenal cortex (glucocorticoid), pituitary (beta-endorphin and ACTH), and central nervous system (CRF) of depressed patients. The hyperactivity of the sympathoadrenomedullary system and the HPA axis in major depression is described in detail, including the pathophysiological and treatment implications of these findings.