Kuhn C M, Bartolome M B
J Pharmacol Exp Ther. 1985 Jul;234(1):204-10.
This study reports the endocrine effects of chronic methadone (METH) administration. Two treatment regimens were tested: a constant (5 mg/kg/day, CD) or increasing dose (5 mg/kg twice daily, increasing 1 mg/kg/day, ID). Basal hormone levels and endocrine responses to opiate challenge were determined on days 5, 10 and 20 and after withdrawal. METH effects on hormone secretion varied with treatment duration, dose and hormone. Tolerance to METH effects on corticosterone (CS), prolactin (PRL), growth hormone (GH), thyroid-stimulating hormone (TSH) and luteinizing hormone (LH) developed during the ID regimen and basal CS, TSH and LH levels were altered. In addition, serum testosterone, T3 and T4 decreased significantly during this regimen. In contrast, only CS secretion was affected markedly by the CD regimen. Resting levels were elevated by day 5 and the CS response to acute METH challenge was reversed. Tolerance also developed to METH-induced TSH suppression, but only with longer treatment. Similarly, basal TSH and LH levels were affected only with longer treatment. Basal PRL, GH and LH levels and LH, PRL and GH responses to acute METH challenge were not affected by the CD regimen. Changes in basal CS and TSH levels observed in these studies probably reflect abstinence, as even more pronounced changes occurred after naloxone-precipitated abstinence and suppressed rather than reversed responses were observed if animals were withdrawn for 36 hr before testing. Tolerance in some endocrine systems appears to be quite long-lasting, as CS, TSH and PRL responses to METH challenge were still decreased 3 weeks after withdrawal from the ID regimen.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究报告了长期服用美沙酮(METH)的内分泌效应。测试了两种治疗方案:恒定剂量(5毫克/千克/天,CD)或递增剂量(每天两次,每次5毫克/千克,每天增加1毫克/千克,ID)。在第5天、第10天、第20天以及戒断后,测定基础激素水平和对阿片类药物激发的内分泌反应。美沙酮对激素分泌的影响随治疗持续时间、剂量和激素的不同而变化。在ID方案治疗期间,对美沙酮对皮质酮(CS)、催乳素(PRL)、生长激素(GH)、促甲状腺激素(TSH)和促黄体生成素(LH)的作用产生了耐受性,基础CS、TSH和LH水平发生了改变。此外,在此方案治疗期间,血清睾酮、T3和T4显著下降。相比之下,CD方案仅对CS分泌有明显影响。到第5天时静息水平升高,对急性美沙酮激发的CS反应发生了逆转。对美沙酮诱导的TSH抑制也产生了耐受性,但仅在治疗时间较长时出现。同样,基础TSH和LH水平仅在治疗时间较长时受到影响。基础PRL、GH和LH水平以及LH、PRL和GH对急性美沙酮激发的反应不受CD方案的影响。在这些研究中观察到的基础CS和TSH水平的变化可能反映了戒断情况,因为在纳洛酮诱发的戒断后出现了更明显的变化,并且如果在测试前动物戒断36小时,则观察到的反应是抑制而非逆转。某些内分泌系统的耐受性似乎相当持久,因为从ID方案戒断3周后,CS、TSH和PRL对美沙酮激发的反应仍然降低。(摘要截断于250字)