Beta-endorphin, adrenocorticotropic hormone and cortisol secretion in abstinent alcoholics

Marchesi, Carlo; Chiodera, P.; Ampollini, P.; Volpi, R.; Coiro, V.

doi:10.1016/s0165-1781(97)00101-7

Cited by 42 publications

(32 citation statements)

References 19 publications

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“…First, glucocorticoid levels clearly fluctuate according to individuals' length of abstinence. For example, as compared with non-alcohol-dependent controls, actively drinking alcohol-dependent men exhibit elevated basal 24-hr urinary free cortisol levels (Wand and Dobs, 1991), and hypercortisolemia is generally observed in very recently (7 days or less) abstinent alcohol-dependent patients and in alcohol-dependent patients undergoing acute withdrawal (Marchesi et al, 1997;von Bardeleben et al, 1989). In contrast to most other studies, the alcohol-dependent patients in our study had been abstinent, on average, for more than 4 months.…”

Section: Discussioncontrasting

confidence: 60%

Stress Hormone Dysregulation at Rest and After Serotonergic Stimulation Among Alcohol‐Dependent Men With Extended Abstinence and Controls

Anthenelli

Maxwell

Geracioti

et al. 2001

Alcoholism Clin & Exp Res

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Alcohol-dependent men with extended abstinence differed from age- and race-matched non-alcohol-dependent men in resting AM and fenfluramine-induced plasma cortisol levels. This dysfunction in glucocorticoid homeostatic mechanisms was associated with alcoholism and not with smoking or ASPD. We also observed a nonsignificant statistical trend for plasma ACTH levels to be elevated among alcohol-dependent men along the descending limb of the response curve. Alcohol-dependent men seemed to have inherited or acquired damage to 5-HT-regulated LHPA axis function, the precise mechanisms and sites of which remain to be determined.

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Section: Discussioncontrasting

confidence: 60%

Stress Hormone Dysregulation at Rest and After Serotonergic Stimulation Among Alcohol‐Dependent Men With Extended Abstinence and Controls

Anthenelli

Maxwell

Geracioti

et al. 2001

Alcoholism Clin & Exp Res

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“…These results are in accordance with those from studies in non-surgical patients, which reported normalised reaction of the central part of the hypothalamic-pituitary-adrenal axis as well as normalised catecholamine response to (non-surgical) stress within 1 to 4weeks after withdrawal. 21 22 The cortisol synthesis and metabolism, however, may still be disturbed after this period,21 which may explain the comparable high concentrations of serum cortisol in the groups.…”

Section: Discussionmentioning

confidence: 99%

Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial

Tønnesen

Rosenberg

Nielsen

et al. 1999

BMJ

253

189

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Objective To evaluate the influence of preoperative abstinence on postoperative outcome in alcohol misusers with no symptoms who were drinking the equivalent of at least 60 g ethanol/day. Design Randomised controlled trial. Setting Copenhagen, Denmark. Subjects 42 alcoholic patients without liver disease admitted for elective colorectal surgery. Interventions Withdrawal from alcohol consumption for 1 month before operation (disulfiram controlled) compared with continuous drinking. Main outcome measures Postoperative complications requiring treatment within the first month after surgery. Perioperative immunosuppression measured by delayed type hypersensitivity; myocardial ischaemia and arrhythmias measured by Holter tape recording; episodes of hypoxaemia measured by pulse oximetry. Response to stress during the operation were assessed by heart rate, blood pressure, serum concentration of cortisol, and plasma concentrations of glucose, interleukin 6, and catecholamines. Results The intervention group developed significantly fewer postoperative complications than the continuous drinkers (31% v 74%, P = 0.02). Delayed type hypersensitivity responses were better in the intervention group before (37 mm 2 v 12 mm 2 , P = 0.04), but not after surgery (3 mm 2 v 3 mm 2 ). Development of postoperative myocardial ischaemia (23% v 85%) and arrhythmias (33% v 86%) on the second postoperative day as well as nightly hypoxaemic episodes (4 v 18 on the second postoperative night) occurred significantly less often in the intervention group. Surgical stress responses were lower in the intervention group (P<0.05). Conclusions One month of preoperative abstinence reduces postoperative morbidity in alcohol abusers. The mechanism is probably reduced preclinical organ dysfunction and reduction of the exaggerated response to surgical stress.

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“…In alcohol dependent persons, HPA-axis abnormalities experienced during early abstinence may contribute to dysphoria, craving and ultimately the high rate of relapse during this period (Marchesi et al 1997;Tsigos and Chrousos 1995). It is intriguing that administration of a single dose of an opioid antagonist (Farren et al 1999;King et al 1998;Wand et al 1998) results in acute stimulation of the HPA-axis, perhaps contributing to alleviation of craving as reported in earlier clinical trials (Volpicelli et al 1992).…”

Section: Discussionmentioning

confidence: 99%

Naltrexone Dampens Ethanol-Induced Cardiovascular and Hypothalamic- Pituitary-Adrenal Axis Activation

McCaul

2001

Neuropsychopharmacology

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Alcohol ingestion activates the autonomic nervous system and the hypothalamic-pituitary-adrenal axis. This study examined naltrexone effects on alcohol-induced increases in physiological responses and their association with alcohol liking. Using a within-subjects design, heavy drinking men (N ϭ 19) were maintained on each of three naltrexone doses (0, 50, and 100 mg, p.o.) over an 8-day inpatient stay. Within each naltrexone dose, subjects had three alcohol challenge sessions (none, moderate, high) The brain opioid system has been proposed to be part of the neurocircuitry involved in alcohol reward and heavy alcohol drinking (Froehlich and Wand 1997;Gianoulakis and deWaele 1994;Reid et al. 1991). Pharmacological studies indicate that opioid receptor antagonists, such as naloxone hydrochloride and naltrexone, decrease alcohol self-administration in animal models (Altshuler et al. 1980;Froehlich et al. 1990;Hubbell et al. 1986Hubbell et al. , 1991Marfaing-Jallat et al. 1983;Samson and Doyle 1985;Weiss et al. 1990). Clinical trials demonstrated that naltrexone reduces alcohol drinking and self-reported "high," alcohol craving, as well as relapse rates in recently abstinent outpatient alcohol-dependent patients (O'Malley et al. 1992;Volpicelli et al. 1992Volpicelli et al. , 1995 . These findings led to naltrexone's approval by the Food and Drug Administration as a pharmacotherapeutic agent for the treatment of alcohol dependence. Naltrexone is thought to reduce alcohol-induced high and relapse by binding to opioid receptors in discrete brain regions associated with reward and craving, and to prevent receptor activation by alcohol-induced release of endogenous opioid peptides.Alcohol induces a variety of acute physiological responses when consumed in moderate-to-high doses. It is well established that intoxicating doses of alcohol increase heart rate (Docter et al. 1966;Iwase et al. 1995 McCaul et al. 1989;Sellers et al. 1972;Turkkan et al. 1988;van de Borne et al. 1997). These heart rate increases are hypothesized to be positively associated with the reinforcing or appetitive motivational effects of alcohol (Peterson et al. 1996) . Alcohol has less predictable effects on blood pressure, with reports of blood pressure increases (Iwase et al. 1995;Sellers et al. 1972) and no effects following alcohol ingestion (Turkkan et al. 1988;van de Borne et al. 1997). Finally, alcoholinduced peripheral vasodilation and associated skin temperature increases have been consistently reported (Iwase et al. 1995;Turkkan et al. 1988) and is thought to be one explanation for the lack of a consistent rise in blood pressure after alcohol consumption.Acute administration of intoxicating doses of alcohol also activates the hypothalamic-pituitary-adrenal (HPA) axis thereby increasing ACTH and glucocorticoid levels (Inder et al. 1995;Rivier et al. 1984;Waltman et al. 1993). It remains unclear whether alcohol-induced activation of the HPA axis has any relationship to its reinforcing properties. Rodent studies show that alcohol increases pla...

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Beta-endorphin, adrenocorticotropic hormone and cortisol secretion in abstinent alcoholics

Cited by 42 publications

References 19 publications

Stress Hormone Dysregulation at Rest and After Serotonergic Stimulation Among Alcohol‐Dependent Men With Extended Abstinence and Controls

Stress Hormone Dysregulation at Rest and After Serotonergic Stimulation Among Alcohol‐Dependent Men With Extended Abstinence and Controls

Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial

Naltrexone Dampens Ethanol-Induced Cardiovascular and Hypothalamic- Pituitary-Adrenal Axis Activation

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