Nikolaou Kakia, Kapoukranidou Dorothea, Ndungu Samuel, Floros Georgios, Kovatsi Leda
a Consultant Psychiatrist, Head of the Addictions Department IANOS , Papanikolaou General Hospital of Thessaloniki-Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece.
b Associate Professor, Department of Physiology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece.
J Psychoactive Drugs. 2017 Jul-Aug;49(3):233-241. doi: 10.1080/02791072.2017.1312644. Epub 2017 Apr 26.
Pre-clinical studies show that, following chronic opioid exposure, oxytocin neurons exhibit over-excitation upon withdrawal, causing an increase in oxytocin brain and plasma levels. Relevant clinical data on humans are scarce. This study investigates the opioid withdrawal stress effect on oxytocin plasma levels in humans. We evaluated 57 male chronic heroin users in a residential detoxification program. We determined plasma oxytocin levels by ELISA and measured the stress effects of withdrawal using the COWS scale for opioid withdrawal, the VAS scale for craving, and the Hamilton scales for anxiety and depression on the second day of admission. Out of the 57 patients enrolled in the study, 27 completed the 21-day program, while the remaining 30 dropped out prior to completion. Plasma oxytocin levels were significantly higher in those individuals who dropped out than in those who completed the program. Participants who dropped out at some stage scored higher in the COWS, VAS-Craving, and Hamilton-anxiety scales, indicating a higher stress and explaining the higher oxytocin levels. In addition, plasma oxytocin levels correlated positively with the scores achieved in the COWS and Hamilton-anxiety scales. Higher withdrawal stress levels are associated with higher plasma oxytocin levels and early treatment discharge.
临床前研究表明，长期接触阿片类药物后，催产素神经元在戒断时表现出过度兴奋，导致大脑和血浆中催产素水平升高。关于人类的相关临床数据很少。本研究调查了阿片类药物戒断应激对人类血浆催产素水平的影响。我们评估了57名参加住院戒毒项目的男性慢性海洛因使用者。我们通过酶联免疫吸附测定法测定血浆催产素水平，并在入院第二天使用阿片类药物戒断临床观察量表（COWS）评估戒断的应激效应，使用视觉模拟量表（VAS）评估渴求程度，使用汉密尔顿焦虑量表和抑郁量表评估焦虑和抑郁程度。在参与研究的57名患者中，27名完成了为期21天的项目，其余30名在项目完成前退出。退出者的血浆催产素水平显著高于完成项目者。在某个阶段退出的参与者在COWS量表、VAS-渴求量表和汉密尔顿焦虑量表上得分更高，表明应激程度更高，这也解释了催产素水平更高的原因。此外，血浆催产素水平与COWS量表和汉密尔顿焦虑量表的得分呈正相关。更高的戒断应激水平与更高的血浆催产素水平以及早期治疗出院有关。
