The renin–angiotensin system: a possible new target for depression
João Vian,
Círia Pereira,
Victor Chavarria,
Cristiano Köhler,
Brendon Stubbs,
João Quevedo,
Sung-Wan Kim,
André F. Carvalho,
Michael Berk,
Brisa S. Fernandes
Affiliations
João Vian
Psychiatry and Mental Health Department, Centro Hospitalar Lisboa Norte
Círia Pereira
Psychiatry and Mental Health Department, Centro Hospitalar Lisboa Norte
Victor Chavarria
Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar (PSM)
Cristiano Köhler
Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará
Brendon Stubbs
Health, Social Care and Education, Anglia Ruskin University
João Quevedo
Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth)
Sung-Wan Kim
Department of Psychiatry, Chonnam National University Medical School
André F. Carvalho
Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará
Michael Berk
Deakin University, IMPACT Strategic Research Centre, School of Medicine, University Hospital Geelong, Barwon Health
Brisa S. Fernandes
Deakin University, IMPACT Strategic Research Centre, School of Medicine, University Hospital Geelong, Barwon Health
Abstract Depression remains a debilitating condition with an uncertain aetiology. Recently, attention has been given to the renin–angiotensin system. In the central nervous system, angiotensin II may be important in multiple pathways related to neurodevelopment and regulation of the stress response. Studies of drugs targeting the renin–angiotensin system have yielded promising results. Here, we review the potential beneficial effects of angiotensin blockers in depression and their mechanisms of action. Drugs blocking the angiotensin system have efficacy in several animal models of depression. While no randomised clinical trials were found, case reports and observational studies showed that angiotensin-converting enzyme inhibitors or angiotensin receptor blockers had positive effects on depression, whereas other antihypertensive agents did not. Drugs targeting the renin–angiotensin system act on inflammatory pathways implicated in depression. Both preclinical and clinical data suggest that these drugs possess antidepressant properties. In light of these results, angiotensin system-blocking agents offer new horizons in mood disorder treatment.
