Efficacy of treatments targeting hypothalamic-pituitary-adrenal systems
for major depressive disorder: a meta-analysis
Abstract
Abnormal hypothalamic-pituitary-adrenal (HPA) axis has been implicated
in major depressive disorder (MDD). The aims of this meta-analysis were
to determine the effect and safety profile of HPA-targeting medications
for MDD. World of Science and PubMed databases were comprehensively
searched up to March 2021. All randomized controlled trials (RCTs) and
open-label trials exploring antiglucocorticoid and related medications
in patients with depression were included. In the meta-analysis, we
identified 16 RCTs and seven open-label studies that included 2972
subjects. Our study suggested that patients with MDD may benefit from
mifepristone and V1B receptor antagonist treatments that have tolerable
side effects. HPA-based medications are promising for depression
treatment. However, additional high-quality RCTs, including head-to-head
trials, are needed.