库欣综合症（CS）如果未经治疗，将导致显著的发病率和死亡率。皮质醇正常化是治疗的关键目标。垂体手术仍然是库欣病（CD）的一线治疗方法，但有时不可行，失败或复发并发症。医疗治疗历来被认为是一种减轻症状的治疗方法。但是，在最近几年，由于新药物的可用性和常用药物在临床实践中的重新评估，对这个话题的兴趣日益增长。在本文中，我们将讨论CS的医疗治疗的当前选择和未来方向，旨在最适合患者的特点和偏好。通过Pubmed和ClinicalTrials.gov进行了关于已经批准和研究治疗的广泛文献搜索。可用的药物包括抑制ACTH分泌的抑制剂，类固醇合成抑制剂和糖皮质激素受体拮抗剂。此外，在未受控制的患者中可以使用在不同水平上起作用的药物组合。由于仍然没有标准化的药物治疗方法，并且由于缺乏比较研究，尚未建立一种药物优越于另一种药物的优势，因此每次临床医生的选择都应该是适合患者的。年龄，性别，肿瘤特征，高皮质醇症的严重程度，共病/并发症，每种药物的作用迅速程度，副作用，药物相互作用，禁忌症，可用性，患者的偏好和成本均应考虑在内。

: Cushing's syndrome (CS) is associated with significant morbidity and mortality if it is not treated. Cortisol normalisation is a key goal to treatment. Pituitary surgery remains the first-line approach for Cushing's disease (CD), but sometimes it is impracticable, unsuccessful or complicated by recurrence. Medical therapy has been historically considered a palliative treatment. However, in the latest years interest on this topic has grown due to both the availability of new drugs and the re-evaluation of the old, commonly used drugs in clinical practice.: In this article we will discuss the current options and future directions of medical therapy for CS, aiming atfitting best patients' characteristics and preferences. An extensive literature search regarding already approved and investigational therapies was conducted through Pubmed and ClinicalTrials.gov. Available drugs include inhibitors of ACTH secretion, steroidogenesis inhibitors and glucocorticoid receptor antagonists. Also, combination of drugs acting at different levels can be used in uncontrolled patients.: Since there is still no standardized pharmacological approach and the superiority of one drug over another has not been established yet due to the lack of comparative studies, each time clinicians' choices should be patient-tailored. Age, gender, tumor features, severity of hypercortisolism, comorbidities/complications, rapidity of action of each drug, side effects, drug-drug interactions, contraindications, availability, patients' preferences and costs should be all taken into account.