No effect of 5-day treatment with acetylsalicylic acid (aspirin) or the beta-blocker propranolol (Inderal) on free cortisol responses to acute psychosocial stress: a randomized double-blind, placebo-controlled study.
BACKGROUND
The characterization of an individual's hypothalamic-pituitary-adrenal axis stress response is a main research topic in neuropsychobiology since alterations have been causally linked to several disease states. Over the last years, several studies focused on the identification of sources of inter- and intraindividual variability, but there is still a paucity of experimental data on the effect of different pharmaceuticals on cortisol responses to acute psychological stress. Therefore, in this randomized double-blind placebo-controlled study, we investigated the effect of treatment with two popular and clinically used pharmaceuticals on stress-related cortisol responses, namely acetylsalicylic acid (aspirin), a known prostaglandin synthesis inhibitor, and the beta-blocker propranolol (Inderal), a nonselective beta-receptor antagonist.


METHODS
For 5 days, 73 healthy subjects (50 men, 23 women; mean age 47.3 +/- 7.7 years) received either a daily oral dose of 100 mg aspirin, 80 mg propranolol (Inderal), aspirin + propranolol, or placebo. After treatment, subjects were confronted with the Trier Social Stress Test, a widely-used standardized psychosocial stress protocol. Cortisol responses were measured by six saliva samples taken before and after the stress exposure.


RESULTS
Subjects showed a significant cortisol increase after stress (p < 0.0001). The four treatment groups did not differ in their cortisol responses (group effect p > 0.44; interaction p > 0.97). Additionally, controlling for gender, age, smoking status, body mass index, mean arterial blood pressure or pre-stress cortisol levels yielded similar results in the total sample as well as in the male or female subgroups, respectively.


CONCLUSIONS
Neither short-term treatment with aspirin nor propranolol altered the acute free cortisol response to psychological stress in healthy adults.
Kudielka
Brigitte M
BM
Department of Theoretical and Clinical Psychobiology, Graduate School of Psychobiology, University of Trier, Trier, Germany.
Fischer
Joachim E
JE
Metzenthin
Petra
P
Helfricht
Susanne
S
Preckel
Daniel
D
von Känel
Roland
R
D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D001241:Aspirin / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use*; D013315:Stress, Psychological / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D010975:Platelet Aggregation Inhibitors; D011433:Propranolol; D001241:Aspirin; D006854:Hydrocortisone