Elsevier

Psychoneuroendocrinology

Volume 37, Issue 12, December 2012, Pages 1922-1928
Psychoneuroendocrinology

Naltrexone effects on cortisol secretion in women and men in relation to a family history of alcoholism: Studies from the Oklahoma Family Health Patterns Project

https://doi.org/10.1016/j.psyneuen.2012.04.006Get rights and content

Summary

Naltrexone evokes a cortisol response through its blockade of central opioid receptors on the hypothalamic-pituitary-adrenocortical axis (HPA). The magnitude of this cortisol response may be useful as a probe for central opioid activity in different groups of subjects. Accordingly, the present study examined the effect of opioid blockade on the HPA in 70 women and 58 men with (N = 41) and without (N = 87) a family history of alcoholism, using a randomized, placebo-controlled, double blind administration of oral naltrexone (50 mg). Saliva cortisol was sampled at baseline prior to placebo or naltrexone and again every 30 min over the next 180 min. Women had significantly larger cortisol responses to naltrexone than did the men, F = 6.88, p < 0.0001. There were no significant differences in cortisol response between groups differing in family history of alcoholism, F = 0.65, p > 0.69. The present results confirm that women have much greater central opioid restraint on the HPA than men do and that this endogenous restraint is unmasked by opioid blockade. However the results provide no evidence of a differential central opioid tonus in persons with a family history of alcoholism at this dose of naltrexone. The cortisol response to naltrexone may be a useful probe for central opioid activity in women and to a lesser degree in men.

Section snippets

Overview

The Oklahoma Family Health Patterns Project is a study of healthy young FH+ and FH− adults with the goal of understanding preexisting differences between these groups that might provide insights into risk factors in persons who have not yet developed problem drinking or drug use habits. The parent project currently has 407 participants of whom a subset underwent the naltrexone protocol.

Subjects

Naltrexone testing included 132 subjects (74 females) recruited through community advertisement, however 4

Results

There were no differences between men and women in the FH groups on major demographic and background characteristics (Table 1). Cortisol values on naltrexone and placebo days are shown in Fig. 1. In order to establish that the groups had equivalent levels of cortisol secretion under basal conditions, we carried out a preliminary analysis of cortisol values at each time point on placebo days on sex and FH groups using a repeated measure ANOVA. There was a significant effect of period reflecting

Discussion

The present study confirms that women have larger and longer lasting cortisol responses to 50 mg of naltrexone than do men. Perhaps more interestingly, the results provide no confirmation that FH+ are more reactive than FH− to that dose of naltrexone. These findings provide several points for consideration in relation to naltrexone's utility as a probe for central opioid activity in relation to risk for alcoholism.

In light of our present findings we reexamined studies of cortisol responses to

Role of the funding source

The funding sources had no role in the design of the study or in the analysis and interpretation of the results. The content is solely the view of the authors and does not necessarily represent the official view of the National Institutes of Health or the VA.

Conflict of interest statement

The authors have no financial interest in any product associated with this research.

Acknowledgements

This work was supported by the Department of Veterans Affairs, the National Institutes of Health, NIAAA (R01 AA12207), NIRR (M01 RR14467, UL1 RR025767, KL2 RR025766, and RR025766), and NHLBI (F32 HL083689).

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