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They are used to treat [[Cushing's syndrome]].<ref name="Dang_2007" /> These drugs have also been investigated for their potential therapeutic benefits in various psychiatric disorders, particularly [[Major depressive disorder|depression]] and [[psychosis]].<ref name="Garner_2016">{{cite journal | vauthors = Garner B, Phillips LJ, Bendall S, Hetrick SE | title = Antiglucocorticoid and related treatments for psychosis | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 1 | pages = CD006995 | date = January 2016 | pmid = 26725721 | pmc = 10337649 | doi = 10.1002/14651858.CD006995.pub2 }}</ref><ref name = "McIsaac_2009">{{cite journal | vauthors = McIsaac SA, Westrin Å, Young AH | title = Antiglucocorticoids in psychiatry. | journal = Advances in Psychiatric Treatment. | date = 2009 | volume = 15 | issue = 4 | pages = 242–249 | doi = 10.1192/apt.bp.105.001834 }}</ref> The rationale behind using antiglucocorticoids in psychiatry stems from the observed dysregulation of the [[hypothalamic-pituitary-adrenal]] (HPA) axis in many psychiatric conditions, which often manifests as elevated cortisol levels.<ref name = "McIsaac_2009" /><ref name="Strawbridge_2021">{{cite journal | vauthors = Strawbridge R, Jamieson A, Hodsoll J, Ferrier IN, McAllister-Williams RH, Powell TR, Young AH, Cleare AJ, Watson S | title = The Role of Inflammatory Proteins in Anti-Glucocorticoid Therapy for Treatment-Resistant Depression | journal = Journal of Clinical Medicine | volume = 10 | issue = 4 | date = February 2021 | page = 784 | pmid = 33669254 | pmc = 7920038 | doi = 10.3390/jcm10040784 | doi-access = free }}</ref> == Types == There are several types of antiglucocorticoid drugs, including: # Cortisol synthesis inhibitors: These drugs, such as [[metyrapone]], [[aminoglutethimide]], and [[ketoconazole]], work by blocking the production of [[cortisol]] in the [[adrenal gland]]s.<ref name="Kling_2009">{{cite journal | vauthors = Kling MA, Coleman VH, Schulkin J | title = Glucocorticoid inhibition in the treatment of depression: can we think outside the endocrine hypothalamus? | journal = Depression and Anxiety | volume = 26 | issue = 7 | pages = 641–9 | date = 2009 | pmid = 19133699 | pmc = 3640810 | doi = 10.1002/da.20546 }}</ref> # Glucocorticoid receptor antagonists: [[Mifepristone]] (RU-486) is the primary example of this class, which directly blocks the action of cortisol at its receptor sites.<ref name="Garner_2016" /><ref name="Kling_2009" /> # Steroid hormones: [[Dehydroepiandrosterone]] (DHEA) has been studied for its potential antiglucocorticoid effects.<ref name="Garner_2016" /> == Therapeutic applications == === Cushing's syndrome === Antiglucocorticoid drugs are a treatment option for Cushing's syndrome, a condition characterized by excessive cortisol production. These medications are primarily used in two scenarios: as preoperative treatment to manage symptoms and reduce surgical risks, and as a long-term solution when surgery has failed or is not feasible.<ref name = "NBK236375">{{cite book | chapter = Chapter 5: Antiglucocorticoid Effects of Antiprogestins. | author = Institute of Medicine (US) Committee on Antiprogestins: Assessing the Science | veditors = Donaldson MS, Dorflinger L, Brown SS, etal | title = Clinical Applications of Mifepristone (RU 486) and Other Antiprogestins: Assessing the Science and Recommending a Research Agenda. | location = Washington (DC) | publisher = National Academies Press (US) | date = 1993 | url = https://www.ncbi.nlm.nih.gov/books/NBK236375/ }}</ref><ref name="Dang_2007">{{cite journal | vauthors = Dang CN, Trainer P | title = Pharmacological management of Cushing's syndrome: an update | journal = Arquivos Brasileiros de Endocrinologia e Metabologia | volume = 51 | issue = 8 | pages = 1339–48 | date = November 2007 | pmid = 18209872 | doi = 10.1590/s0004-27302007000800020 }}</ref> The main antiglucocorticoid agents employed in treating Cushing's syndrome include [[steroidogenesis inhibitor]]s such as [[metyrapone]] and [[ketoconazole]], which block cortisol production, and [[mifepristone]] (RU-486), which directly antagonizes the [[glucocorticoid receptor]].<ref name="Dang_2007" /> Metyrapone and ketoconazole are often preferred as first-line pharmacological treatments, either as monotherapy or in combination, due to their efficacy in controlling [[hypercortisolemia]].<ref name="Dang_2007" /> However, careful monitoring is essential during treatment, as these drugs can potentially cause side effects and, in some cases, lead to [[adrenal insufficiency]].<ref name = "NBK236375" /> While antiglucocorticoid therapy has shown promise in managing Cushing's syndrome, it is generally considered an [[adjunctive treatment]] to surgery, which remains the definitive cure for most cases of the disorder.<ref name="Dang_2007" /> === Psychiatric disorders === The use of antiglucocorticoid drugs for psychiatric disorders has yielded mixed results. Some studies have shown promise in treating major depression, particularly in cases with psychotic features.<ref name="Kling_2009" /> However, a Cochrane review of antiglucocorticoid treatments for psychosis found no significant differences in overall psychotic symptoms, positive symptoms, or negative symptoms when compared to placebo.<ref name="Garner_2016" /> The mechanism of action for antiglucocorticoid drugs in psychiatric disorders is not fully understood. One hypothesis suggests that these drugs may work by reducing glucocorticoid enhancement of [[corticotropin-releasing hormone]] (CRH) action in certain brain regions, such as the [[central nucleus]] of the [[amygdala]].<ref name="Kling_2009" /> Additionally, these drugs may affect glucocorticoid receptor regulation, [[neuroactive steroid]]s, and classical monoamine systems.<ref name="Kling_2009" /> == See also == * [[Corticosteroid]] * [[Antimineralocorticoid]] == References == {{reflist}} {{Glucocorticoids}} {{Glucocorticoidics}} [[Category:Antiglucocorticoids]] {{pharmacology-stub}} </textarea><div class="templatesUsed"><div class="mw-templatesUsedExplanation"><p><span id="templatesused">Pages transcluded onto the current version of this page<span class="posteditwindowhelplinks"> (<a href="/wiki/Help:Transclusion" title="Help:Transclusion">help</a>)</span>:</span> </p></div><ul> <li><a href="/wiki/Template:Abbr" title="Template:Abbr">Template:Abbr</a> (<a 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