可卡因成瘾男性下丘脑-垂体-肾上腺和性腺功能障碍的证据。

IF 2.8 3区 医学 Q2 PSYCHIATRY
European Addiction Research Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI:10.1159/000535584
Karen D Ersche, Jan Stochl, Annette B Brühl, Mark Gurnell
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引用次数: 0

摘要

导言:经常吸食可卡因与包括性腺功能减退在内的荷尔蒙功能障碍有关,可导致疲劳、体力下降、性功能障碍和生活质量下降。然而,在科学成瘾文献中,可卡因对内分泌的影响大多未得到充分报道,而且在许多情况下,治疗服务中也未涉及可卡因对内分泌的影响。这些不良影响之所以不受重视,可能是因为人们对可卡因的使用缺乏认识,也没有将其与可卡因的使用联系起来,因此只有在出现急性/紧急问题时才会认识到这些不良影响:我们评估了26名健康男性和27名可卡因依赖男性的昼夜内分泌功能(肾上腺皮质激素[ACTH]、皮质醇和睾酮),并在一项双盲、安慰剂对照的实验医学研究中考察了激素水平的变化对单次服用40毫克去甲肾上腺素再摄取抑制剂阿托西汀的反应:结果:与健康对照组相比,可卡因依赖男性的促肾上腺皮质激素和皮质醇的昼夜变化和阿托西汀诱导的变化显示出更大的可变性。有趣的是,尽管在服用阿托西汀后促肾上腺皮质激素会急剧上升,但皮质醇的反应却有所减弱,三分之一的可卡因依赖男性睾酮水平低于正常水平:我们的研究结果表明,可卡因依赖男性的垂体和肾上腺反应之间可能存在脱节,性腺功能减退的发生率较高,因此迫切需要对可卡因的内分泌影响及其临床意义进行更多研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evidence of Hypothalamic-Pituitary-Adrenal and -Gonadal Dysfunction in Cocaine-Addicted Men.

Introduction: Regular cocaine use has been associated with hormonal dysfunction including hypogonadism, which can lead to fatigue, reduced stamina, sexual dysfunction, and impaired quality of life. However, cocaine's endocrine effects are largely under-reported in the scientific addiction literature and, in many cases, are not addressed within treatment services. The low profile of these adverse effects might be attributable to a lack of awareness and linkage with cocaine use, such that they are recognized only when an acute/emergency problem arises.

Methods: We assessed endocrine diurnal function (adrenocorticotrophic hormone [ACTH], cortisol, and testosterone) in 26 healthy and 27 cocaine-dependent men and examined changes in hormone levels in response to a single 40 mg dose of the noradrenaline re-uptake inhibitor atomoxetine in a double-blind, placebo-controlled experimental medicine study.

Results: When compared with healthy controls, diurnal and atomoxetine-induced changes in ACTH and cortisol showed greater variability in cocaine-dependent men. Interestingly, despite an exaggerated rise in ACTH following atomoxetine, an attenuated cortisol response was observed, and one-third of cocaine-dependent men had subnormal testosterone levels.

Conclusion: Our findings point to a potential disconnection between the pituitary and adrenal responses in cocaine-dependent men, a higher rate of hypogonadism, and a pressing need for more research into the endocrine effects of cocaine and their clinical implications.

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来源期刊
European Addiction Research
European Addiction Research SUBSTANCE ABUSE-PSYCHIATRY
CiteScore
6.80
自引率
5.10%
发文量
32
审稿时长
>12 weeks
期刊介绍: ''European Addiction Research'' is a unique international scientific journal for the rapid publication of innovative research covering all aspects of addiction and related disorders. Representing an interdisciplinary forum for the exchange of recent data and expert opinion, it reflects the importance of a comprehensive approach to resolve the problems of substance abuse and addiction in Europe. Coverage ranges from clinical and research advances in the fields of psychiatry, biology, pharmacology and epidemiology to social, and legal implications of policy decisions. The goal is to facilitate open discussion among those interested in the scientific and clinical aspects of prevention, diagnosis and therapy as well as dealing with legal issues. An excellent range of original papers makes ‘European Addiction Research’ the forum of choice for all.
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