title: The effects of exogenous progesterone on drug craving and stress arousal in cocaine dependence: impact of gender and cue type.
abstract: OBJECTIVE
  Exogenous progesterone has been shown to attenuate the rewarding effects of cocaine. However, its effects on provoked drug craving, stress arousal and cognitive performance has not been systematically investigated in cocaine dependent men and women. Thus, we conducted a double-blind placebo-controlled study assessing the efficacy of progesterone in reducing provoked drug craving, stress system arousal and improving cognitive performance in cocaine dependent men and women.
  
  
  METHODS
  Forty-two early abstinent treatment-seeking cocaine dependent individuals were randomly assigned to either daily doses of placebo (12M/9F) or micronized progesterone (12M/9F) (400 mg/day), for 7 days. Under experimental conditions, all subjects were exposed to three 5-min personalized guided imagery conditions (stress, cocaine cue, relaxing), one per day, consecutively in a random, counterbalanced order. Subjective craving, mood, hypothalamic-pituitary-adrenal (HPA) and cardiovascular output, and a cognitive measure of inhibitory control (Stroop Color Word Task) were assessed pre- and post imagery.
  
  
  RESULTS
  Progesterone relative to placebo significantly decreased cue-induced craving and cortisol responses and increased cue-induced ACTH. In addition, women but not men receiving progesterone reported lower ratings of negative emotion and higher ratings of relaxed mood following stress exposure. Improved Stroop performance was observed in all participants receiving progesterone, across all conditions.
  
  
  CONCLUSIONS
  Progesterone was selectively effective in reducing cocaine cue-induced but not stress-related cocaine craving as well as specific measures of the provoked arousal state. Findings suggest that progesterone's effects on drug craving and arousal are moderated by both the type of environmental cue exposure and gender.
authors: The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519, USA. Electronic address: helen.fox@yale.edu.
authors: Helen C
authors: HC
authors: Fox
authors: Mehmet
authors: M
authors: Sofuoglu
authors: Peter T
authors: PT
authors: Morgan
authors: Keri L
authors: KL
authors: Tuit
authors: Rajita
authors: R
authors: Sinha
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D000339:Affect; D000428:Alcohol Drinking / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D001143:Arousal / Q000187:drug effects*; D001794:Blood Pressure; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D015897:Comorbidity; D003463:Cues; D003863:Depression / Q000453:epidemiology; D004311:Double-Blind Method; D004644:Emotions; D004958:Estradiol / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011374:Progesterone / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D012064:Relaxation Therapy; D012727:Sex Characteristics; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000188:drug therapy / Q000503:physiopathology*; D057190:Stroop Test
chemical_list: D011374:Progesterone; D004958:Estradiol; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
keywords: Cocaine dependence; Drug cue; Gender; Progesterone; Stress; Stroop
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