Attenuation of the hypothalamic-pituitary-adrenal axis responsivity to the Trier Social Stress Test by the benzodiazepine alprazolam
Attenuation of the hypothalamic-pituitary-adrenal axis responsivity to the Trier Social Stress Test by the benzodiazepine alprazolam
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DOI：
10.1016/j.psyneuen.2006.09.009
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发表时间：
2006-11-01
影响因子：
3.7
通讯作者：
Hellhammer, Juliane
中科院分区：
文献类型：
--
作者：
Fries, Eva;Hellhammer, Dirk H.;Hellhammer, Juliane
关于常用抗焦虑药物对两个主要应激系统（下丘脑-垂体-肾上腺（HPA）轴和交感神经-肾上腺-髓质（SAM）轴）的心理诱发反应的影响，人们知之甚少。本研究的目的是评估抗焦虑药阿普唑仑对HPA和SAM轴对标准化心理社会应激协议（特里尔社会应激测试（TSST））的反应的影响。46名年龄在18 - 45岁之间的健康、不吸烟、不服药的配偶被邀请到实验室一次，并在TSST前1小时分别接受1 mg阿普唑仑或安慰剂的单次口服剂量，观察ACTH、皮质醇、肾上腺素、去甲肾上腺素的分泌以及心率、血压和心理状态的变化（焦虑、觉醒、良好情绪、平静）。阿普唑仑预处理的受试者表现出强烈的钝化反应，促肾上腺皮质激素以及总和游离皮质醇的TSST。尽管阿普唑仑治疗的受试者在TSST前即刻显示出显著较低的收缩压，但肾上腺素、去甲肾上腺素的分泌和对应激试验的心率变化均与安慰剂治疗的受试者不同。关于心理参数，阿普唑仑明显降低主观评分的问卷量表“清醒”和增加评级的规模“好心情”，而评级的规模评估“状态焦虑”或“搅拌”不受影响。在健康的科目，我们观察到的阿普唑仑的影响的分离的内分泌和自主反应的心理压力。精神反应似乎被阿普唑仑的镇静作用所掩盖。(c)2006爱思唯尔有限公司版权所有。
Little is known about effects of commonly used anxiolytic drugs on psychologically evoked responses of two major stress systems, the hypothalamic-pituitary-adrenal (HPA) and the sympathetic-adrenal-medullary (SAM) axis. The purpose of the present study was to assess effects of the anxiolytic alprazolam on responses of the HPA and the SAM axes to a standardized psychosocial stress protocol, the Trier Social Stress Test (TSST). Forty-six healthy, non-smoking, non-medicated mates, aged between 18 and 45 years, were invited once to the laboratory and received a single oral dose of 1 mg alprazolam or placebo, respectively, 1 h prior to the TSST The secretion of ACTH, cortisol, epinephrine, norepinephrine as well as changes in heart rate, blood pressure, and psychological states (anxiety, wakefulness, good mood, calmness) in response to the TSST were measured. Subjects pre-treated with alprazolam showed a strongly blunted response of ACTH as well as total and free cortisol to the TSST. Whereas alprazolam-treated subjects displayed significantly Lower systolic blood pressure immediately before the TSST, neither the secretion of epinephrine, norepinephrine nor changes of heart rate in response to the stress test differed from placebo-treated subjects. Regarding psychological parameters, alprazolam clearly decreased subjective ratings on the questionnaire scale "wakefulness" and increased ratings on the scale "good mood", whereas ratings on scales assessing "state anxiety" or "agitation" were not affected.In healthy subjects, we observed a dissociation of the effects of alprazolam on the endocrine and the autonomic response to psychosocial stress. The psychological responses seemed to be masked by sedative properties of alprazolam. (c) 2006 Elsevier Ltd. All rights reserved.