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Titolo:
Salivary cortisol measurements during a medically assisted alcohol withdrawal
Autore:
Keedwell, PA; Poon, L; Papadopoulos, AS; Marshall, EJ; Checkley, SA;
Indirizzi:
Natl Addict Ctr, London, England Natl Addict Ctr London EnglandNatl Addict Ctr, London, England
Titolo Testata:
ADDICTION BIOLOGY
fascicolo: 3, volume: 6, anno: 2001,
pagine: 247 - 256
SICI:
1355-6215(200107)6:3<247:SCMDAM>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORTICOTROPIN-RELEASING HORMONE; ABSTINENT ALCOHOLICS; CUSHINGS-DISEASE; DEPRESSION; DEPENDENCE; AXIS; PREVALENCE; ETHANOL; SCALE; SERUM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Keedwell, PA Maudsley Hosp, Natl Alcohol Unit, Denmark Hill, London SE5 8AZ, England Maudsley Hosp Denmark Hill London England SE5 8AZ Z, England
Citazione:
P.A. Keedwell et al., "Salivary cortisol measurements during a medically assisted alcohol withdrawal", ADDICT BIOL, 6(3), 2001, pp. 247-256

Abstract

Previous studies using plasma cortisol estimations have suggested that hypothalmo-pituitary-axis (HPA) activation occurs in alcohol-dependent patients during alcohol withdrawal. The present study set out to confirm this finding using salivary cortisol assays, which are a better indicator of plasma free cortisol, the fraction which exerts its physiological effects. Nine alcohol dependent patients provided four saliva samples (at 10 a.m., 2 p.m., 6 p.m. and 10 p.m.) on days 1, 3 and 7 of a medically assisted alcohol withdrawal (corresponding to 1, 3 and 7 days following the last drink, respectively). Withdrawal symptom severity, craving and mood disturbance were also measured. A group of non-alcohol-dependent individuals, without psychiatricor medical disorder, gave four samples at the same times on one day only. Mean daily cortisol levels in our alcohol-dependent population, as calculated by the area under the cur ve (AUC), decreased significantly over time (mean AUC (nmol/l/hour) on day 1 = 149, on day 7 = 85.7, p = 0.009) and were significantly higher than controls on each day (mean AUC in controls = 28.3, p = 0.001). The cortisol response showed a similar temporal trend to withdrawal symptom severity and mood disturbance. This is consistent with previous studies measuring plasma cortisol in alcohol withdrawal. However, the magnitude of the effect in our study was greater, and in contrast to some previous studies, levels were far from normal by day 7. The comparatively lowcortisol response in our one mildly dependent patient suggests that there may be a relationship between dependence severity and the size of the cortisol response to withdrawal. Salivary cortisol sampling could prove to be a useful prognostic tool, with implications for subsequent withdrawal symptomseverity, mood disturbances, risk of relapse and alcohol-related cognitivedecline. There are implications for developing new treatments for alcohol withdrawal but more studies are needed.

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Documento generato il 27/01/20 alle ore 13:57:29