Depression was an affective disorder, and the incidence of depression
was increasing, which was projected to be the first disease burden
worldwide by 2030. Therefore, it is particularly urgent to find new
anti-depressant curative. The renin-angiotensin system (RAS) was
important for regulating blood pressure, water, and electrolyte balance.
Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor
blockers (ARB) were commonly used as first-line antihypertensive agents.
A large number of basic studies confirmed that RAS played a key role in
hypertension, affective disorders, and neurological diseases. Recently,
studies have found that RAS blockers (ACEI/ARB) acted on the classical
ACE/AngII/AT1 receptor pathway and ACE2/Ang-(1-7)/Mas receptor pathway,
which may have promising clinical value for the treatment of anxiety
disorders and depression. Therefore, the modulation role of RAS in the
nervous system has progressively come to light. This review addresses
the overview of the RAS, the relationship between RAS and
depression/anxiety, and the potential mechanisms of RAS blockers in the
therapy of affective disorders, involving brain inflammation, HPA axis,
oxidative stress, and BDNF. The evidence for positive effects of RAS
blockers on depression and anxiety alone or comorbidity was reviewed,
hoping to provide a reference for new clinical uses, which go beyond
blood pressure management.