下丘脑-垂体-肾上腺皮质轴活动：药物抗渴求治疗的一个靶点？
Hypothalamic-pituitary-adrenocortical axis activity: a target of pharmacological anticraving treatment?
作者信息
Kiefer Falk, Jahn Holger, Otte Christian, Naber Dieter, Wiedemann Klaus
机构信息
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
出版信息
Biol Psychiatry. 2006 Jul 1;60(1):74-6. doi: 10.1016/j.biopsych.2005.11.023. Epub 2006 Feb 14.
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.
背景
目前正在探讨下丘脑 - 垂体 - 肾上腺皮质（HPA）轴的活性与酒精摄入行为之间的关联。我们研究了药物抗渴望治疗的疗效与酒精中毒复发预防治疗中HPA轴活性之间的关系。
方法
在160例酒精中毒患者中，我们在使用纳曲酮和/或阿坎酸进行安慰剂对照的复发预防治疗期间测量了血浆促肾上腺皮质激素（ACTH）和皮质醇。
结果
在安慰剂组中，早期戒酒期间ACTH和皮质醇水平下降。纳曲酮和阿坎酸治疗阻止了这种变化过程。治疗期间ACTH和皮质醇升高与复发风险降低相关。
结论
这些发现表明，HPA反应性增强可能有助于抗渴望化合物对酒精中毒的复发预防作用。
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