HIPOTHALAMO-

HIPOFISE-ADRENAL
AXIS
 Corteks
Sistem Limbik
Cerebri

Hipothalamus

Hipofise

Kelenjar
Endokrin
 CNS-Hipothalamus-Hipofise Antor
 Cortisol
• CRTH dan ACTH juga
dihasilkan diluar HT
• ACTH di batang otak,
thalamus dan sistem
limbik berperan untuk
mengatur perhatian,
memori dan learning
 Glukokortikoid
• Pada penderita depresi
terjadi peningkatan
hormon  ggn
neurogenesis
hipokampus mengecil
 HPA Axis
Under stress, the hypothalamus secretes
corticotropin-releasing hormone (CRH), and this
provokes the release of adrenocorticotropic
hormone (ACTH) from the pituitary. ACTH triggers
the secretion of glucocorticoids from the adrenal
cortex
HPA hyperactivity :
1. major depression
2. susceptibility to infectious
diseases
3. cardiovascular problems
Hyporeactivity of the HPA axis
1. autoimmune processes : lupus erythematosis, multiple sclerosis,
neurodermatitis
2. fibromyalgia,
3. Chronic fatigue syndrome, and
4. rheumatoid arthritis
CNS-Hipothalamus-Hipofise
Ant or
Respon terhadap stress dan berperan dalam mengontrol mood
dan perilaku
 Kortisol
 Diatur oleh corticotropin-releasing hormon dan
adrenocorticotropic hormone
 Variasi diurnal, peak : pukul 6 -7
 Fungsi :
 mempengaruhi sintesis protein dan meningkatkan sintesis
enzim di CNS
 Hipercortisolism (cushing’s syndrome)
 Gangguan mood (depresi, mania), confusion, psikosis,
 Peningkatan dan hilangnya irama sekresi : depresi, mania,
obsesive compulsive disorder
 Hipocortisolism (addison’s disease)
 Apatis, Kelelahan, Depresi,
HPA axis dysfunction in unmedicated major depressive disorder and its
normalization by pharmacotherapy correlates with alteration of neural
activity in prefrontal cortex and limbic/paralimbic regions
Psychiatry Research: Neuroimaging 155 (2007) 245–256

depressed patients remitted with

antidepressant treatment were
accompanied by resolution of
HPA dysregulation and alteration
of regional glucose metabolism in
the prefrontal cortical, limbic and
paralimbic regions.
Metabolisme Glukosa
 ♂ dan ♀

1. Numerous studies have

shown that glucocorticoid
levels are higher in females
than in males after HPA axis
stimulation
2. Psychosocial stress  ACTH and
free cortisol increases in men were
Gn-RH, LH dan FSH
Gn-RH
struktur mirip TRH
HT, juga di amygdala dan mid brain
Neuromodulator : inhibisi dan eksitasi post synaptic
Berperan dalam sexual behavior dan alertness dan anxiety
Anorexia nervosa : kegagalan sistem pengaturan gonad
penurunan Gn-RH, gagalnya irama sirkadian atau
variasi bulanan kadar Gn-RH
Pubertas : perubahan di pengaturan sistem gonad 
metal illnesses
 Thyroid
 Berperan penting untuk perkembangan
SSP
 Hipertiroid :
• Usia muda : anxiety, restlessness dan irritability
• Lanjut : apathetic, depresi
 TRH
• HT, Brain stem,medula spinalis, area
periventrikular, amygdala, dan ganglion basalis
• Pada umumnya inhibitor post sinaptik
• Penurunan  depresi
 Growth Hormon (GH)
 Diatur oleh GH-RF dan GH-IF
(somatostatin)
 Stress dan aktifitas  meningkatkan
GH
 Somatostatin
• Konsentrasi tinggi : cortek serebri dan
amygdala
• meningkatkan sedasi dan menurunkan
aktifitas, depresi
• Berperan dalam mengatur Ach 
Alzheimer’s disease
 Prolaktin
 Diatur Prolactin-IH dan Prolactin-RH,
 Meningkat pada keadaan : tidur,
excercise, pregnancy dan menyusui
 Neuroleptic menyebabkan
peningkatan prolaktin 
menghambat reseptor dopamin di
tuberoinfundibular : prolaktin IH
 Prolaktin
 One of the more important groups of
drug within this class are the
antipsychotics (dopamine
antagonists), which are used in the
treatment of schizophrenia.
Hyperprolactinaemia is thought to be
caused by these agents blocking the
D2 receptors on the lactrotroph cells
and thus preventing inhibition of
prolactin secretion
 Peningkatan Prolaktin
 In females :
• Irregular menstrual periods (oligomenorrhea) or no menstrual periods
(amenorrhea)
• Milky discharge from the breasts (galactorrhea) when not pregnant or breast-
feeding
• Painful intercourse due to vaginal dryness
• Acne and excessive body and facial hair growth (hirsutism)
 In males, prolactinoma can cause:
• Erectile dysfunction
• Decreased body and facial hair
• Uncommonly, enlarged breasts (gynecomastia)
 In both sexes, prolactinoma can cause:
• Low bone density
• Loss of interest in sexual activity
• Headaches
• Infertility
• Lethargi, irritability dan haus
 Melanocyte Stimulating Hormone
 ??  memori dan learning
CNS-Hipothalamus-Hipofise Postor
Vasopressin
◦ Attention, memory, learning dan
antidepresan
◦ Meningkat : pain, exercise, morphin,
barbiturat, nicotine
◦ Menurun : alkohol
Melatonin
Disintesa dari serotonin
Diproduksi di kelenjar Pineal
melalui reseptor beta-adrenergik.
Berperan dalam irama sirkadian
dan pematangan sexual
 System Peptide
Endogenous Opioid
◦ Berperan pengaturan nyeri, anxiety dan memori, sexual
activity, feeding, suhu, TD
◦ Ggn : schizophrenia, affective illness, eating disorder
Substance P
◦ Pengaturan kontrol motorik dan persepsi nyeri
Cholescystokinin
◦ Bersama dengan dopamin  patophysiologi dari
schizophrenia
Vasoactive Intestinal Peptide
◦ ??
Angiostensi II
◦ Meningkatkan rangsang haus
Neurotensin
◦ Nyeri, sensitivitas, suhu