Neuroendocrine markers for drug action: Hypothalamus-Pituitary-Adrenal axis

Publication Type:

Book Chapter


Encyclopedia of Psychopharmacology, Springer (2010)



DOI Name (links to online publication)



The hypothalamic-pituitary-adrenal (HPA) axis is a neuroendocrine system that coordinates adaptation of body and brain function to environmental demands: i.e., day- and sleep-related events and stressors (Chrousos and Gold 1992). The hormones of the HPA axis operate in a feedforward cascade from hypothalamic corticotropin releasing hormone (CRF) and vasopressin via pituitary adrenocorticotropin hormone (ACTH) to adrenocortical secretion of glucocorticoids in the circulation. Glucocorticoids in turn feedback on brain and pituitary to shut down the activated HPA axis. In this chapter the mechanism underlying HPA axis functioning is first described, and subsequently the different tests being used to evaluate HPA axis reactivity. Then, specific psychiatric disorders characterized by dysregulation of the HPA axis are discussed and genetic and early life susceptibility factors are referred to.