TABLE 2.
Glucocorticoid-receptor-modifying drugs in brain disorders
| Drug | Neurological effects | Refs | |
|---|---|---|---|
| Steroidal agonist | Dexamethasone | • Prevents tissue edema in meningitis cases | [100,137–140,142, 171,180,192] |
| • Reduces peritumoral edema in glioma and meningioma cases | |||
| • Inhibits apoptotic protein expression, inflammation and blood–brain barrier breakdown in eosinophilic meningitis | |||
| • Reduces meningitis-associated mortality and cerebrospinal fluid pressure | |||
| • Reduces risk of cerebral swelling during subdural grid electroencephalography | |||
| • Treats epileptic encephalopathy with continuous spike-and-wave during sleep | |||
| Methylprednisolone | • Acute treatment for relapses of multiple sclerosis (MS) | [145–149,181,182] | |
| • Reduces edema in brain tumors and surgical procedures | |||
| • Treats children with epileptic encephalopathy without underlying lesions | |||
| Hydrocortisone | • Reduces blood–brain barrier breakdown in inflammation | [183,184] | |
| • Reduces levels of serotonin in the brain | |||
| Betamethasone | • Reduces vascular density and suppresses expression of vascular endothelial growth factor | [55] | |
| • Increases pericyte coverage of neurovasculature | |||
| Nonsteroidal agonist | Ginsenosides | • Improve outcome in rat stroke model | [153,185] |
| • Reduce blood–brain barrier damage in experimental autoimmune encephalitis MS model | |||
| Antagonist | Mifepristone | • Neuroprotection in traumatic brain injury in rats | [157–162,186] |
| • Treatment of glioma and selective induction of tumor cell death | |||
| • Improvement in mood disorders | |||
| • Improves working memory and reduces depressive symptoms in bipolar disorder | |||
| Relicorilant (CORT125134) | • Treats Cushing disease and tumor pathology (Phase II/III clinical trial) | [164–166] | |
| Ketoconazole | • Treatment of refractory depression and major depressive disorder | [187] | |
| • Treatment of depressive symptoms in bipolar disorder | |||
| Aminogluthetimide | • Protection from ischemic injury and NMDA excitotoxicity | [188] | |
| Selective antagonist | LGD5552 | • Prevents incidence of disease in experimental autoimmune encephalitis MS rat model | [171] |
| CORT118335 | • Reduction of stress response | [163] | |
| CORT108297 | • Reduction of stress response, with delayed recovery from stress | [164] | |
| Modulator | Melatonin | • Reverses glucocorticoid-induced enhancement of cytotoxicity and reduction of hippocampal cell proliferation | [189] |
| Icariin | • Ameliorates disease pathology and improves clinical score in experimental autoimmune encephalitis rat model | [190,191] | |