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Hypothalamic-Pituitary-Adrenocortical Axis Activity: A Target of Pharmacological Anticraving Treatment?

Published:February 15, 2006DOI:https://doi.org/10.1016/j.biopsych.2005.11.023

      Background

      An association between the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis and alcohol intake behavior is currently discussed. We examined the relationship between efficacy of pharmacological anticraving treatment and HPA axis activity in the relapse prevention treatment of alcoholism.

      Methods

      In 160 patients suffering from alcoholism, we measured plasma adrenocorticotropic hormone (ACTH) and cortisol during placebo-controlled relapse prevention treatment with naltrexone and/or acamprosate.

      Results

      In the placebo group, ACTH and cortisol decreased during early abstinence. Treatment with naltrexone and acamprosate prevented this course. Increased ACTH and cortisol during treatment was associated with a reduced risk of relapse.

      Conclusions

      These findings suggest that heightened HPA responsiveness might contribute to relapse-preventing effects of anticraving compounds in alcoholism.

      Key Words

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      References

        • Adinoff B.
        • Iranmanesh A.
        • Veldhuis J.
        • Fisher L.
        Disturbance of the stress response. The role of the HPA axis during alcohol withdrawal and abstinence.
        Alcohol Health Res World. 1998; 22: 67-72
        • Adinoff B.
        • Krebaum S.R.
        • Chandler P.A.
        • Ye W.
        • Brown M.B.
        • Williams M.J.
        Dissection of hypothalamic-pituitary-adrenal axis pathology in 1-month-abstinent alcohol-dependent men, part 1.
        Alcohol Clin Exp Res. 2005; 29: 517-527
        • Adinoff B.
        • Krebaum S.R.
        • Chandler P.A.
        • Ye W.
        • Brown M.B.
        • Williams M.J.
        Dissection of hypothalamic-pituitary-adrenal axis pathology in 1-month-abstinent alcohol-dependent men, part 2.
        Alcohol Clin Exp Res. 2005; 29: 528-537
        • Anton R.F.
        • Moak D.H.
        • Latham P.
        The Obsessive Compulsive Drinking Scale.
        Alcohol Clin Exp Res. 1995; 19: 92-99
        • Junghanns K.
        • Backhaus J.
        • Tietz U.
        • Lange W.
        • Bernzen J.
        • Wetterling T.
        • et al.
        Impaired serum cortisol stress response is a predictor of early relapse.
        Alcohol Alcohol. 2003; 38: 189-193
        • Kiefer F.
        • Jahn H.
        • Tarnaske T.
        • Helwig H.
        • Briken P.
        • Holzbach R.
        • et al.
        Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism.
        Arch Gen Psychiatry. 2003; 60: 92-99
        • Olive M.F.
        • Mehmert K.K.
        • Koenig H.N.
        • Camarini R.
        • Kim J.A.
        • Nannini M.A.
        • et al.
        A role for corticotropin releasing factor (CRF) in ethanol consumption, sensitivity, and reward as revealed by CRF-deficient mice.
        Psychopharmacology (Berl). 2003; 165: 181-187
        • O’Malley S.S.
        • Krishnan-Sarin S.
        • Farren C.
        • Sinha R.
        • Kreek J.
        Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis.
        Psychopharmacology (Berl). 2002; 160: 19-29
        • Sillaber I.
        • Rammes G.
        • Zimmermann S.
        • Mahal B.
        • Zieglgansberger W.
        • Wurst W.
        • et al.
        Enhanced and delayed stress-induced alcohol drinking in mice lacking functional CRH1 receptors.
        Science. 2002; 296: 931-933