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Hypothalamic-pituitary-adrenal system adaptation to detoxification in alcohol-dependent patients is affected by family history of alcoholism

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Holsboer,  F
Max Planck Institute of Psychiatry, Max Planck Society;

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Zimmermann, U., Hundt, W., Spring, K., Grabner, A., & Holsboer, F. (2003). Hypothalamic-pituitary-adrenal system adaptation to detoxification in alcohol-dependent patients is affected by family history of alcoholism. Biological Psychiatry, 53(1), 75-84.


Cite as: http://hdl.handle.net/11858/00-001M-0000-000E-9F53-4
Abstract
Background: Alcohol withdrawal profoundly affects the hypothalamic-pituitary-adrenocortical (HPA) system. We investigated whether a family history of alcoholism modulates HPA response to pharmacologic intervention during detoxification in alcohol-dependent patients. Methods: Sixteen family history negative (FH-N) and 19 family history positive (FH-P) alcohol-dependent patients were admitted for withdrawal. All 35 patients were investigated 1 week after remission of withdrawal symptoms; 17 patients were also tested during acute withdrawal. Dexamethasone 1.5 mg was given orally at 11 PM, followed by 100 mug corticotropin-releasing hormone (hCRH) administered intravenously at 3 PM the following day. Plasma adrenocorticotropic hormone (ACTH) and cortisol concentrations were determined at 0, 30, 45, 60, and 75 min after CRH. Results: During withdrawal, cortisol but not ACTH secretion was increased in patients compared with 19 control subjects matched for age and gender. After withdrawal, cortisol was normal in FH-P but still increased in FH-N patients versus control subjects, and ACTH was marginally decreased in FH-P patients only. Both hormones were increased in FH-N versus FH-P patients. Conclusions: Recovery from alcohol withdrawal-induced impairment of HPA system regulation occurs earlier in FH- P than FH-N patients, indicating that the efficacy of central neuroadaptation to this ethanol-related stimulus may be related to genetic factors. (C) 2003 Society of Biological Psychiatr