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Hypothalamic-Pituitary-Adrenal Axis Functioning and Cerebrospinal Fluid Corticotropin Releasing Hormone and Corticotropin Levels in Alcoholics After Recent and Long-term Abstinence
Bryon Adinoff, MD;
Peter R. Martin, MD;
George H. A. Bone, MD;
Michael J. Eckardt, PhD;
Laurie Roehrich;
David T. George, MD;
Howard B. Moss, MD;
Robert Eskay, PhD;
Markku Linnoila, MD, PhD;
Philip W. Gold, MD
Arch Gen Psychiatry. 1990;47(4):325-330.
Abstract
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• We assessed the plasma corticotropin (adrenocorticotropic hormone) and cortisol responses to ovine corticotropin releasing hormone (oCRH) and the cerebrospinal fluid levels of CRH and corticotropin in alcoholics at various durations of abstinence and compared these variables with age-equivalent controls. Alcoholics who were tested at 1 week of abstinence (n = 11) demonstrated a significantly attenuated corticotropin response to oCRH compared with their response at 3 weeks of abstinence. Nine of these alcoholic patients demonstrated a significantly blunted corticotropin response at both 1 and 3 weeks of abstinence compared with controls (n =15). A markedly exaggerated corticotropin response to oCRH, associated with tachycardia, was exhibited by 2 alcoholics at both 1 and 3 weeks of abstinence. Alcoholics who were abstinent greater than 3 weeks did not differ in their response to oCRH compared with controls. Controls demonstrated a significant inverse correlation between baseline cortisol levels and the cortisol response to oCRH. This correlation was not evident in any of the alcoholic groups, including those patients who were abstinent greater than 6 months. There was a positive correlation between cerebrospinal fluid concentrations of CRH and corticotropin in all patient groups. These findings indicated that alcoholics have significantly altered hypothalamic-pituitary-adrenal axis functioning up to 3 weeks following the cessation of drinking, with a more subtle impairment present for greater than 6 months following abstinence.
Author Affiliations
From Laboratory of Clinical Studies, DICBR, National Institute on Alcohol Abuse and Alcoholism (Drs Adinoff, Martin, Bone, Eckardt, George, Moss, Eskay, and Linnoila, and Ms Roehrich), and the Biological Psychiatry Branch, National Institute of Mental Health (Dr Gold), Bethesda, Md. Dr Adinoff is now with the Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston. Dr Martin is now with the Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tenn. Ms Roehrich is now with the Department of Psychology, University of South Florida, Tampa. Dr Moss is now with the Western Psychiatric Institute and Clinic, University of Pittsburgh (Pa) School of Medicine.
Footnotes
Accepted for publication July 10, 1989.
Presented, in part, at the 14th Annual Meeting of the American Psychiatric Association, Montreal, Canada, May 12, 1988, and at the Annual Meeting of the Research Society on Alcoholism, Wild Dunes, SC, June 4, 1988.
Reprint requests to Alcohol/Drug Dependence Treatment Program, 116A, 109 Bee St, Veterans Administration Medical Center, Charleston, SC 29403 (Dr Adinoff).
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