Hypothalamic-pituitary-adrenocortical axis activity: a target of pharmacological anticraving treatment?
BACKGROUND
An association between the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis and alcohol intake behavior is currently discussed. We examined the relationship between efficacy of pharmacological anticraving treatment and HPA axis activity in the relapse prevention treatment of alcoholism.


METHODS
In 160 patients suffering from alcoholism, we measured plasma adrenocorticotropic hormone (ACTH) and cortisol during placebo-controlled relapse prevention treatment with naltrexone and/or acamprosate.


RESULTS
In the placebo group, ACTH and cortisol decreased during early abstinence. Treatment with naltrexone and acamprosate prevented this course. Increased ACTH and cortisol during treatment was associated with a reduced risk of relapse.


CONCLUSIONS
These findings suggest that heightened HPA responsiveness might contribute to relapse-preventing effects of anticraving compounds in alcoholism.
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany. falk.kiefer@zi-mannheim.de
Falk
F
Kiefer
Holger
H
Jahn
Christian
C
Otte
Dieter
D
Naber
Klaus
K
Wiedemann
D000077443:Acamprosate; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000427:Alcohol Deterrents / Q000494:pharmacology* / Q000627:therapeutic use; D000437:Alcoholism / Q000097:blood / Q000188:drug therapy; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000494:pharmacology* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D013654:Taurine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D013997:Time Factors
D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D013654:Taurine; D009271:Naltrexone; D000324:Adrenocorticotropic Hormone; D000077443:Acamprosate; D006854:Hydrocortisone