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DOI: 10.1055/s-2005-871244
© Georg Thieme Verlag Stuttgart · New York
A Neuroendocrinological Hypothesis on Gender Effects of Naltrexone in Relapse Prevention Treatment
Letter to the EditorPublication History
Received: 20.7.2004
Revised: 5.10.2004
Accepted: 29.11.2004
Publication Date:
18 July 2005 (online)
The ability of naltrexone to increase hypothalamo-pituitary-adrenocortical (HPA)-axis activity was recently reported to be associated with its effects on the reduction of craving for alcohol. We now present data showing naltrexone to be more efficacious in female alcoholics. Since HPA-axis activity displays gender effects, the interaction of naltrexone with HPA-axis might be interpreted as a key mechanism of action that could explain the observed gender differences in the abstinence maintenance treatment of alcohol addiction.
References
- 1 Chick J, Anton R, Checinski K, Croop R, Drummond D C, Farmer R, Labriola D, Marshall J, Moncrieff J, Morgan M Y, Peters T, Ritson B. A multicentre, randomized, double-blind, placebo-controlled trial of Naltrexone in the treatment of alcohol dependence or abuse. Alcohol Alcohol. 2000; 35 587-593
- 2 Gastpar M, Bonnet U, Böning J, Mann K, Schmidt L G, Soyka M, Wetterling T, Kielstein V, Labriola D, Croop R. Lack of efficacy of naltrexone in the prevention of alcohol relapse: results from a German multicenter study. J Clin Psychopharmacol. 2002; 22 592-598
- 3 Kiefer F, Jahn H, Schick M, Wiedemann K. Alcohol self-administration, craving and HPA-axis activity: an intriguing relationship. Psychopharmacol. 2002; 164 239-240
- 4 Kiefer F, Jahn H, Tarnaske T, Helwig H, Briken P, Holzbach R Stracke R, Naber D, Wiedemann K. Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2003; 60 92-99
- 5 Klein L C, Jamner L D, Alberts J, Orenstein M D, Levine L. Sex differences in salivary cortisol levels following naltrexone administration. J Appl Biobehav Res. 2000; 5 144-153
- 6 Krystal J H, Cramer J A, Krol W F, Kirk G F, Rosenheck R A. Naltrexone in the treatment of alcohol dependence. N Engl J Med. 2001; 345 1734-1739
- 7 O'Malley S S, Krishnan-Sarin S, Farren C, O'Connor P G. Naltrexone-induced nausea in patients treated for alcohol dependence: clinical predictors and evidence for opioid-mediated effects. J Clin Psychopharmacol. 2000; 20 69-76
- 8 O'Malley S S, Krishnan-Sarin S, Farren C, Sinha R, Kreek J. Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis. Psychopharmacol. 2002; 160 19-29
- 9 Streeton C, Whelan G. Naltrexone, a relapse prevention maintenance treatment of alcohol dependence: a meta-analysis of randomized controlled trials. Alcohol Alcohol. 2001; 36 544-552
- 10 Zimmermann U, Spring K, Koller G, Holsboer F, Soyka M. Hypothalamic-pituitary-adrenal system regulation in recently detoxified alcoholics is not altered by one week of treatment with acamprosate. Pharmacopsychiatry. 2004; 37 98-102
Prof. Dr. Falk Kiefer
Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH) Mannheim
University of Heidelberg
Germany
Phone: +49 621 1703 3522
Fax: +49 621 1703 3505
Email: kiefer@zi-mannheim.de