Besirli A, Eşel E, Özsoy S, Turan T
Department of Psychiatry, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.
Department of Psychiatry, Erciyes University, Kayseri, Turkey.
Pharmacopsychiatry. 2014 Jul;47(4-5):151-5. doi: 10.1055/s-0034-1381983. Epub 2014 Jun 17.
It is thought that naltrexone may play a significant role in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis response to stress. We investigated the HPA axis response following single-dose oral naltrexone administration in the early phase of alcohol withdrawal.
Cortisol and adrenocorticotrophic hormone (ACTH) responses to naltrexone were measured in alcohol-dependent males (n=23) and in healthy males (n=20). Blood samples were collected for cortisol and ACTH measurements before administering (0 min) 50 mg naltrexone at 08.00 in the morning, and at 60, 90, 120 and 180 min after administering naltrexone.
Naltrexone administration resulted in a significant ACTH response in the patients while cortisol and ACTH responses were found to be significant in the controls. Cortisol response was not large enough to reach significance in the patients. ACTH level changes as a response to naltrexone in the patients were lower than that in the controls.
The study revealed blunted cortisol and attenuated ACTH responses to naltrexone in early alcohol withdrawal. This study may have shown impairment in adrenal and pituitary levels during alcohol withdrawal.
据认为，纳曲酮可能在调节下丘脑 - 垂体 - 肾上腺（HPA）轴对应激的反应中发挥重要作用。我们研究了在酒精戒断早期单剂量口服纳曲酮后HPA轴的反应。
在酒精依赖男性（n = 23）和健康男性（n = 20）中测量对纳曲酮的皮质醇和促肾上腺皮质激素（ACTH）反应。在早晨08:00给予50 mg纳曲酮之前（0分钟）以及给予纳曲酮后60、90、120和180分钟采集血样用于测量皮质醇和ACTH。
给予纳曲酮后患者出现显著的ACTH反应，而对照组中皮质醇和ACTH反应显著。患者的皮质醇反应不够大，未达到显著水平。患者中对纳曲酮反应的ACTH水平变化低于对照组。
该研究揭示了在酒精戒断早期对纳曲酮的皮质醇反应迟钝和ACTH反应减弱。这项研究可能显示了酒精戒断期间肾上腺和垂体水平的损害。
