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      Disturbances of the Stress Response : The Role of the HPA Axis During Alcohol Withdrawal and Abstinence

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          Abstract

          Interactions among the brain, the pituitary gland, and the adrenal glands (i.e., the hypothalamic-pituitary-adrenal [HPA] axis) help regulate the body’s response to stress. The adrenal hormone cortisol plays a key role in stress reduction through its effects on multiple body systems. Excessive cortisol activity during both chronic alcohol administration and withdrawal may underlie some of the clinical complications of alcoholism, including increased risk of infectious diseases; bone, muscle, and reproductive system changes; altered energy metabolism; and disorders of mood and intellect. Despite excessive cortisol levels during intoxication and withdrawal, however, the HPA axis becomes less responsive to stress during abstinence, potentially resulting in an impaired capacity to cope with relapse-inducing stressors.

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          Why stress is bad for your brain.

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            Personality and disinhibitory psychopathology: alcoholism and antisocial personality disorder.

            We discuss the relation between personality factors and two adult forms of disinhibitory psychopathology--alcohol abuse or dependence and antisocial personality disorder. First, we briefly review various methodological issues relevant to research in this area. Next, we review empirical findings relating three broad-band personality trait dimensions neuroticism/emotionality, impulsivity/disinhibition, extraversion/sociability) to both alcohol abuse and dependence and antisocial personality disorder. Finally, theoretical models of the relationship between personality and each of these two disorders are presented. We conclude that although no single personality description is likely to be both a sensitive and specific indicator of either alcoholism or antisocial personality disorder, personality variables are important components of etiological models of these disorders.
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              Stress-induced sensitization and glucocorticoids. I. Sensitization of dopamine-dependent locomotor effects of amphetamine and morphine depends on stress-induced corticosterone secretion.

              Repeated exposures to stress sensitize motor and addictive effects of drugs of abuse. Recently, it has been shown that stress-induced behavioral sensitization depends on the secretion of glucocorticoids. We investigated if sensitization of dopamine-dependent effects of psychostimulants and opioids was influenced by glucocorticoid. Sensitization of the dopaminergic response to drugs is considered the neural substrate of behavioral sensitization and has been implicated in vulnerability to drug abuse. Dopamine-dependent effects of psychostimulants and opioids were evaluated by injecting either amphetamine into the nucleus accumbens (10 micrograms/side) or morphine into the ventral tegmental area (VTA) (1 microgram/side). The locomotor response to psychostimulants and opioids injected in these brain areas depends on the mesencephalic dopaminergic transmission. Drug-induced locomotion was compared in male rats in which corticosterone secretion was either in +tct or experimentally suppressed by an adrenalectomy associated with a substitutive treatment reproducing basal levels of the hormone. Eight days of food restriction (80% of the initial body weight) were used as a stressor. Suppression of stress-induced corticosterone secretion abolished food restriction-induced sensitization of the locomotor effects of intra-accumbens amphetamine and intra-VTA morphine. This effect was corticosterone dependent since the restoration of corticosterone levels in the range of those induced by stress totally reinstates sensitization. Our results suggest that glucocorticoids control stress-induced sensitization by changing the sensitivity of the mesencephalic dopaminergic transmission to drugs of abuse. Since dopaminergic effects of drugs are related to their addictive properties, secretion of glucocorticoids may be one of the factors determining the enhanced vulnerability to drugs observed in stressed subjects.
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                Author and article information

                Journal
                Alcohol Health Res World
                Alcohol Health Res World
                Alcohol Health and Research World
                National Institute on Alcohol Abuse and Alcoholism
                0090-838X
                1998
                : 22
                : 1
                : 67-72
                Affiliations
                Bryon Adinoff, M.D., is the Distinguished Professor of Alcohol and Drug Abuse Research and associate professor in the Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, and medical director of the Substance Abuse Team at the Dallas Veterans Affairs Medical Center, VA North Texas Health Care System, Dallas, Texas. Ali Iranmanesh, M.D., is associate professor of endocrinology in the Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, and is chief of the Endocrine Section and director of the Endocrine Laboratory, Salem VA Medical Center, Salem, Virginia. Johannes Veldhuis, M.D., is a professor of endocrinology in the Department of Medicine and director of the General Clinical Research Center, University of Virginia School of Medicine, Charlottesville, Virginia. Lisa Fisher, Ph.D., is an assistant professor in the Department of Psychiatry, University of Texas Southwestern Medical Center, and a staff psychologist at the Dallas Veterans Affairs Medical Center, VA North Texas Health Care System, Dallas, Texas
                Article
                arh-22-1-67
                6761816
                15706736
                21289854-73e4-4f02-8a0a-d6016860205c
                Copyright @ 1998

                Unless otherwise noted in the text, all material appearing in this journal is in the public domain and may be reproduced without permission. Citation of the source is appreciated.

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                Articles

                aod withdrawal syndrome,physiological stress,hypothalamic-pituitary axis,pituitary-adrenal axis,cortisol,aod abstinence,chronic aode (alcohol and other drug effects),corticotropin rh,arginine,vasopressin,adrenocorticotropic hormone,secretion,metabolic disorder,aodr (alcohol and other drug related) disorder,mood and affect disturbance,personality disorder,infection,drug therapy,literature review

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