Effects of cocaine on the hypothalamic-pituitary-adrenal axis.
BACKGROUND
Cocaine hydrochloride is a psychoactive substance extracted from the leaves of plants called Erythroxylum coca. Cocaine is the second most commonly used drug in the world after cannabis; 20 % of cocaine users will become long-term cocaine-dependent patients. Different routes of administration may be recognized: smokable modality, intranasal and intravenous. Cocaine is a potent stimulant of the sympathetic nervous system and causes structural changes on the brain, heart, lung, liver and kidney. It has long been known that use of cocaine may produce alterations to the endocrine system. Research on behavioral and neuroendocrine effects of cocaine dates back several years ago and has increasingly focused on alterations of the hypothalamic-pituitary-adrenal (HPA) axis, which appears to be the chief target of cocaine effects.


METHODS
Animal (mainly rats and monkeys) and human studies have clearly shown a close relation between cocaine consumption and overdrive of the HPA axis. Such activation is likely involved, though via a still undefined mechanism, in the behavioral and cardiovascular changes of drug abusers as well as in the reinforcement/relapse phenomena. Further studies of the pathophysiology of cocaine addicts will help to devise new therapeutic strategies for these patients.
Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Ospedale Cisanello, via Paradisa 2, 56124, Pisa, Italy. lmanetti@endoc.med.unipi.it.
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Manetti
Neuroendocrinology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20149, Milan, Italy.
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Cavagnini
Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Ospedale Cisanello, via Paradisa 2, 56124, Pisa, Italy.
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Martino
Neuroendocrinology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20149, Milan, Italy.
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Ambrogio
D000818:Animals; D000697:Central Nervous System Stimulants / Q000633:toxicity*; D003042:Cocaine / Q000633:toxicity*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000378:metabolism; D013287:Illicit Drugs / Q000633:toxicity*; D008954:Models, Biological; D009474:Neurons / Q000187:drug effects / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000378:metabolism; D011619:Psychotropic Drugs / Q000633:toxicity*; D015854:Up-Regulation / Q000187:drug effects
D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D011619:Psychotropic Drugs; D003042:Cocaine; D006854:Hydrocortisone