Sex steroid hormones, stress response, and drug craving in cocaine-dependent women: implications for relapse susceptibility.
Sex steroid hormones, stress response, and drug craving in cocaine-dependent women: implications for relapse susceptibility.
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可卡因依赖女性的性类固醇激素、压力反应和药物渴望：对复发易感性的影响。
DOI：
10.1037/1064-1297.15.5.445
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发表时间：
2007
影响因子：
2.3
通讯作者：
Bergquist,KenT
中科院分区：
文献类型：
--
作者：
Sinha,Rajita;Fox,Helen;Hong,Kwang-Ik;Sofuoglu,Mehmet;Morgan,PeterT;Bergquist,KenT
可卡因依赖与对压力和药物渴望的敏感性增强有关。压力引起的渴望和下丘脑-垂体-肾上腺反应性的增加也可以预测可卡因复发的结果。更重要的是，这些反应中的性别差异也有报道。为了进一步了解性别差异的基础，作者研究了性类固醇激素对可卡因依赖女性的主观和生理应激反应以及药物渴望的影响。将低孕酮水平的女性 (n = 5) 与高孕酮水平的女性 (n = 5) 以及雌二醇和孕酮水平中等的女性 (n = 9) 在暴露于压力、可卡因线索和中性意象条件下的反应进行比较。与低孕酮组相比，高孕酮组表现出显着较低的压力诱导和药物提示诱导的可卡因渴望（p<.05），降低的药物提示诱导的焦虑水平（p<.08）以及较低的药物提示诱导的收缩压和舒张压水平。这些数据表明，性类固醇激素对压力和药物提示引起的可卡因渴望、焦虑和心血管反应有显着影响。特别是，周期黄体中期的高孕酮与压力诱发和药物提示诱发的渴望减少以及提示诱发的焦虑和血压反应减少有关。这些发现与之前关于黄体酮对可卡因行为反应影响的临床前和临床研究一致，并需要进一步研究黄体酮对女性压力诱发的可卡因渴望、压力唤醒和可卡因复吸易感性的影响。
Cocaine dependence is associated with an enhanced sensitivity to stress and drug craving. Increases in stress-induced craving and hypothalamic-pituitary-adrenal reactivity are also predictive of cocaine relapse outcomes. More important, sex differences in these responses have also been reported. To further understand the basis of the sex differences, the authors examined the influence of sex steroid hormones on subjective and physiological stress responses and drug craving in cocaine-dependent women. Women who had low progesterone levels (n= 5) were compared with those with high progesterone levels (n= 5) and with those with moderate levels of estradiol and progesterone (n= 9) in their responses during exposure to stress, cocaine cues, and neutral imagery conditions. The high progesterone group showed significantly lower stress-induced and drug cue-induced cocaine craving (p<. 05) and reduced drug cue-induced anxiety levels (p<. 08) and lower drug cue-induced systolic and diastolic blood pressure levels compared with the low progesterone group. These data suggest that there are significant effects of sex steroid hormones on stress and drug cue-induced cocaine craving, anxiety, and cardiovascular responses. In particular, high progesterone during the midluteal phase of the cycle was associated with decreased stress-induced and drug cue-induced craving and decreased cue-induced anxiety and blood pressure responses. These findings are consistent with previous preclinical and clinical studies of progesterone's effects on the behavioral responses to cocaine and warrant further research to examine the effects of progesterone on stress-induced cocaine craving, stress arousal, and cocaine relapse susceptibility in women.