Progesterone Attenuates the Stress Response in Individuals with Alcohol Dependence and Post-Traumatic Stress Disorder - A Pilot Study.

IF 1.5 4区医学 Q3 PSYCHIATRY

Journal of Dual Diagnosis Pub Date : 2024-01-01 Epub Date: 2024-02-01 DOI:10.1080/15504263.2023.2294989

Elizabeth Ralevski, Jenelle Newcomb, Emily Pisani, Diana DeNegre, MacKenzie Peltier, Jane Serrita Jane, Gihyun Yoon, Ismene Petrakis

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引用次数: 0

Abstract

Objective: Evidence from laboratory studies suggests that progesterone may be effective in reducing stress and craving, and may improve cognitive performance in smokers and individuals with cocaine dependence. The objective of this study was to examine if progesterone would attenuate stress-induced craving, anxiety, affect and physiological measures, as well as improve stress-induced cognitive performance (processing speed and selective attention) in individuals diagnosed with alcohol use disorder (AUD) and post traumatic stress disorder (PTSD).

Methods: This laboratory study included (n = 13) participants who were diagnosed with current AUD and PTSD who were randomly assigned to recive either progesterone (200mg bid) or placebo in identical looking capsules for 3 days. On the fourth day they completed a laboratory session. In the morning of the test session, they received the last dose of medication and completed the rest of the laboratory procedures. The procedures included presentation in random order of personalized trauma and neutral scripts with relaxation in between. Main outcomes included measure of craving, anxiety, affect and cognitive performance.

Results: Consistent with other research, trauma scripts produced significantly greater increases in craving, anxiety and negative affect when compared with neutral scripts. Progesterone significantly reduced stress-induced symptoms of craving, anxiety, fear, anger and sadness but had no effect on positive emotions (joy, relaxation). Progesterone was effective in ameliorating stress-induced decreases in cognitive performance.

Conclusions: The findings from this study demonstrate that progesterone can be effective in reducing stress-induced craving, anxiety and negative affect in a laboratory setting in individuals with comorbid AUD and PTSD. Interestingly, progesterone also improved cognitive performance. These findings require replication in a larger clinical trial and may have implications for treatment among individuals with AUD and PTSD.This study was registered as NCT02187224, at www.clinicaltrials.gov.

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黄体酮可减轻酒精依赖症和创伤后应激障碍患者的应激反应--一项试点研究。

目的：实验室研究的证据表明，黄体酮可以有效减轻压力和渴求，并能改善吸烟者和可卡因依赖者的认知能力。本研究旨在探讨黄体酮是否能减轻压力引起的渴求、焦虑、情感和生理指标，以及改善被诊断为酒精使用障碍（AUD）和创伤后应激障碍（PTSD）患者的压力引起的认知能力（处理速度和选择性注意力）：这项实验室研究包括（n = 13）被诊断为当前酗酒和创伤后应激障碍的参与者，他们被随机分配接受黄体酮（200 毫克 bid）或安慰剂（外观相同的胶囊），为期 3 天。第四天，他们完成了一个实验环节。测试当天上午，他们服用了最后一剂药物，并完成了实验室的其他程序。实验过程包括按随机顺序展示个性化创伤和中性脚本，中间进行放松。主要结果包括对渴求、焦虑、情感和认知能力的测量：结果：与其他研究结果一致，与中性脚本相比，创伤脚本明显增加了渴求、焦虑和负面情绪。黄体酮能明显减轻压力引起的渴求、焦虑、恐惧、愤怒和悲伤等症状，但对积极情绪（快乐、放松）没有影响。黄体酮能有效改善压力导致的认知能力下降：本研究的结果表明，在实验室环境中，黄体酮可以有效减少合并有 AUD 和创伤后应激障碍的个体由压力引起的渴求、焦虑和负面情绪。有趣的是，黄体酮还能改善认知能力。这些研究结果需要在更大规模的临床试验中得到验证，并可能对患有 AUD 和创伤后应激障碍的患者的治疗产生影响。该研究已注册为 NCT02187224，网址为 www.clinicaltrials.gov。

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来源期刊

Journal of Dual Diagnosis Multiple-

CiteScore

4.90

自引率

13.60%

发文量

期刊介绍： Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.