Hypothalamic-Pituitary-Adrenocortical Axis Activity in Alcohol-Dependent Patients During Treatment with High-Dose Baclofen

Olga Geisel; Ludwig Schlemm; Rainer Hellweg; Klaus Wiedemann; Christian A. Müller

doi:10.1055/s-0043-124189

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2019; 52(01): 32-37
DOI: 10.1055/s-0043-124189

Original Paper

Hypothalamic-Pituitary-Adrenocortical Axis Activity in Alcohol-Dependent Patients During Treatment with High-Dose Baclofen

Olga Geisel

¹Department of Psychiatry, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany

,

Ludwig Schlemm

²Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany

³Berlin Institute of Health (BIH), Berlin, Germany

⁴London School of Economics and Political Science, London, United Kingdom

,

Rainer Hellweg

¹Department of Psychiatry, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany

,

Klaus Wiedemann

⁵Department of Psychiatry, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany

,

Christian A. Müller

¹Department of Psychiatry, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany

› Author Affiliations

Abstract

Aims Activity of the hypothalamic-pituitary-adrenocortical (HPA) axis has been reported to be affected in alcohol use disorder (AUD). It has been suggested that pharmacological relapse prevention in AUD might exert its effects partly by modulation of HPA axis activity. Here, we assessed the effects of high-dose treatment with baclofen on HPA axis activity in alcohol-dependent patients within a 24-week randomized, placebo-controlled trial (BACLAD study).

Methods Plasma levels of copeptin, adrenocorticotropic hormone (ACTH), and cortisol were measured at 3 timepoints in alcohol-dependent patients during the study. Corresponding plasma levels in healthy controls were assessed once.

Results ACTH blood levels were significantly higher in the group of alcohol-dependent patients compared to controls. In patients receiving individually titrated high-dose baclofen, plasma cortisol levels decreased significantly, whereas no significant alterations were found in the placebo group.

Conclusions Our study underlines again the role of HPA axis alterations in AUD. Furthermore, a decrease in hormonal stress levels during treatment with high-dose baclofen might contribute to the relapse preventive effects of this compound.

Key words

alcohol dependence - baclofen - GABA-B receptor agonist - HPA axis - adrenocorticotropic hormone - cortisol

Full Text

References

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