title: The impact of atrial natriuretic peptide on anxiety, stress and craving in patients with alcohol dependence.
abstract: OBJECTIVE
  Atrial natriuretic peptide (ANP) is well known to modulate fluid and electrolyte homeostasis but also to counter-regulate hypothalamic-pituitary-adrenal (HPA) axis activity. Correspondingly, recent studies suggest an important role of ANP in the neurobiology of anxiety. Preclinical and clinical data now provide evidence for an involvement of ANP in the pathophysiology of addictive behavior. The present study aims to elucidate the effects of ANP on alcohol-dependent patients' anxiety, perceived stress and craving during alcohol withdrawal.
  
  
  METHODS
  A sample of 59 alcohol-dependent inpatients was included in the analysis. A blood sample was taken at day 14 of detoxification in order to assess the concentrations of ANP and cortisol in plasma. In parallel, we assessed patients' alcohol craving, using the Obsessive Compulsive Drinking Scale, as well as anxiety (State-Trait Anxiety Inventory). Patients' stress levels were assessed using the Perceived Stress Scale.
  
  
  RESULTS
  We found a significant negative association between patients' ANP plasma concentrations and anxiety, craving for alcohol and perceived stress. Regression analyses suggest that ANP is a significant predictor both for patients' perceived stress and for the severity of anxiety during early abstinence. The association of patients' ANP plasma levels and craving is suggested to be mediated by perceived stress.
  
  
  CONCLUSIONS
  Our results suggest that the association of patients' ANP plasma levels and craving is mediated by their perceived stress. For this reason, intranasal application of ANP may prove to be a new avenue for the treatment of alcohol dependence in patients exhibiting high levels of perceived stress.
authors.affiliation: Corresponding author: Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany. anne.koopmann@zi-mannheim.de.
authors.forename: Anne
authors.initials: A
authors.lastname: Koopmann
authors.forename: Tagrid
authors.initials: T
authors.lastname: Leménager
authors.forename: Nadine Donata
authors.initials: ND
authors.lastname: Wolf
authors.forename: Iris
authors.initials: I
authors.lastname: Reinhard
authors.forename: Derik
authors.initials: D
authors.lastname: Hermann
authors.forename: Jan
authors.initials: J
authors.lastname: Koch
authors.forename: Klaus
authors.initials: K
authors.lastname: Wiedemann
authors.forename: Falk
authors.initials: F
authors.lastname: Kiefer
mesh_terms: D000437:Alcoholism / Q000097:blood* / Q000150:complications / Q000523:psychology; D001007:Anxiety / Q000097:blood* / Q000150:complications; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D066249:Craving; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000097:blood* / Q000150:complications; D013375:Substance Withdrawal Syndrome / Q000097:blood / Q000150:complications
chemical_list: D015415:Biomarkers; D009320:Atrial Natriuretic Factor; D006854:Hydrocortisone