The role of cortisol suppression on craving for and satisfaction from nicotine in high and low impulsive subjects

Abstract

The rewarding properties of drug self-administration have been shown to depend on mesolimbic dopamine release but also on the availability of corticosterone, as shown in rats. Since this became particularly evident when tested in rat strains bred for high (HR) and low (LR) reactivity to novel stimuli, the role of cortisol and personality in drug craving was investigated in 60 male nicotine-deprived smokers divided according to questionnaire scores into high and low impulsives, a dimension considered to represent HR/LR rats. They either received the peripheral cortisol blocker metyrapone (MET) or the centrally blocking substance dexamethasone (DEX) or placebo (n=20 each) and were then allowed to smoke. MET more than DEX reduced craving for cigarettes during deprivation. This was only observed in low impulsives while high impulsives developed low craving unmodified by blockade of cortisol. Satisfaction from smoking was less achieved with DEX than with MET and not modified by impulsivity. Differences between MET and DEX in influencing craving during deprivation and satisfaction from smoking were discussed on the basis of different glucocorticoid receptors. The mineralocorticoid receptor (MR) seems to be the 'turn on switch' and the glucocorticoid receptor (GR) the 'turn off switch' in mediating the rewarding properties of dopamine in drug self-administration.

Impact of Cortisol on Emotions under Stress and Nonstress Conditions: A Pharmacopsychological Approach

“…When, therefore, looking at the interaction effect obtained 1 h prior to stress evaluation, it becomes evident that mainly dimensions related to activity and arousal (vigor, alertness, and inner relaxation) are the dimensions affected. So the MRs, probably responsible for pushing activity [40], would be active in the nonstress condition, whereas, when additional emotional arousal is induced by the stressor, the occupancy of the GRs may be responsible for the dampening effects observed in the stress condition leading to the significant interactions. When in the condition of drug application 2 hs prior to stress the substance is equally bound to all receptors, the extra emotional arousal caused by the stressor is shifted to the same direction by the drug as the unstimulated emotion.…”

Impulsivity and smoking relapse

“…Kruedelbach, McCormick, Schulz, and Grueneich (1993) found that among inpatient substance abusers, greater impulsivity was associated with higher drug cravings and with increased risk of relapse. Pharmacological challenges that interfere with the rewarding aspects of smoking have been found to elicit higher levels of craving among more impulsive smokers relative to other smokers (Reuter & Netter, 2001;Reuter et al, 2002). Consequently, we also posited that more impulsive smokers' quicker relapse would be at least partially mediated by disproportionately high levels of postquit craving relative to their less impulsive peers.…”

Cortisol as an indicator of dopaminergic effects on nicotine craving

“…The difference 'cravingscore after deprivation minus craving-score at baseline' was used as the dependent variable in the analyses. The craving measure was also used in a previous study where it was described in more detail (Reuter et al, 2002a). Its correlations with traditional craving measures as the QSU (Tiffany and Drobes, 1991) were satisfying (Reuter et al, 2002a).…”

“…Frederick et al (1998) have outlined that corticosteroids are involved in behavioural sensitization to nicotine. Moreover, in a recent experiment (Reuter et al, 2002a) differences in nicotine craving were observed between high and low impulsive smokers after suppression of cortisol synthesis by means of metyrapone and after stimulation of type II glucocorticoid receptors by dexamethasone. Both drugs decreased craving in comparison with placebo only in low impulsive subjects but they had no effect on craving in high impulsives, indicating the relevance of individual differences in these types of investigations.…”