Charles G A, Orsulak P J, Rush A J, Fulton C L
Bristol-Myers Squibb International Corporation, Brussels, Belgium.
Biol Psychiatry. 1995 Jun 1;37(11):811-6. doi: 10.1016/0006-3223(94)00215-O.
Six normal controls participated in two or three individual, intravenous challenges (each separated by 1 week) of saline or one of two doses of arecoline at 8 AM following ingestion of 1 mg dexamethasone at 12 midnight the previous evening. Individuals differed in their subjective and neuroendocrine responses to arecoline. At 2.1 micrograms/kg (n = 4) or 2.8 micrograms/kg (n = 1), four of five subjects evidenced dexamethone suppression test (DST) nonsuppression, which followed the rise in prolactin. Cholinergic side effects and nausea were minimal. At a dose of 4.2 micrograms/kg, four of five subjects evidenced cortisol escape from dexamethasone suppression, which was associated with a substantial rise in prolactin, some subjective cholinergic symptoms, and little to modest nausea. These data are consistent with the notion that cholinergic mechanisms are involved in the escape from dexamethasone suppression. Further, arecoline may be preferable to physostigmine as a cholinergic agonist, since it appears less likely to cause marked cholinergic side effects and significant nausea.
六名正常对照者在头天晚上12点摄入1毫克地塞米松后，于上午8点接受了两次或三次单独的静脉注射挑战（每次间隔1周），注射的是生理盐水或两种剂量之一的槟榔碱。个体对槟榔碱的主观和神经内分泌反应各不相同。在2.1微克/千克（n = 4）或2.8微克/千克（n = 1）剂量下，五名受试者中有四名出现地塞米松抑制试验（DST）未被抑制的情况，这伴随着催乳素的升高。胆碱能副作用和恶心症状轻微。在4.2微克/千克的剂量下，五名受试者中有四名出现皮质醇从地塞米松抑制中逃逸的情况，这与催乳素的大幅升高、一些主观胆碱能症状以及轻微至中度的恶心有关。这些数据与胆碱能机制参与地塞米松抑制逃逸的观点一致。此外，槟榔碱作为胆碱能激动剂可能比毒扁豆碱更可取，因为它似乎不太可能引起明显的胆碱能副作用和严重的恶心。
