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Pharmacopsychiatry 2005; 38(4): 184-186
DOI: 10.1055/s-2005-871244
Letter
Letter to the Editor
© Georg Thieme Verlag Stuttgart · New York

A Neuroendocrinological Hypothesis on Gender Effects of Naltrexone in Relapse Prevention Treatment

Letter to the EditorF. Kiefer1 , 2 , H. Jahn2 , K. Wiedemann2
  • 1Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH) Mannheim, University of Heidelberg, Germany
  • 2Department of Psychiatry, University Hospital of Hamburg, Germany
Further Information

Publication History

Received: 20.7.2004 Revised: 5.10.2004

Accepted: 29.11.2004

Publication Date:
18 July 2005 (online)

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The ability of naltrexone to increase hypothalamo-pituitary-adrenocortical (HPA)-axis activity was recently reported to be associated with its effects on the reduction of craving for alcohol. We now present data showing naltrexone to be more efficacious in female alcoholics. Since HPA-axis activity displays gender effects, the interaction of naltrexone with HPA-axis might be interpreted as a key mechanism of action that could explain the observed gender differences in the abstinence maintenance treatment of alcohol addiction.

References

  • 1 Chick J, Anton R, Checinski K, Croop R, Drummond D C, Farmer R, Labriola D, Marshall J, Moncrieff J, Morgan M Y, Peters T, Ritson B. A multicentre, randomized, double-blind, placebo-controlled trial of Naltrexone in the treatment of alcohol dependence or abuse.  Alcohol Alcohol. 2000;  35 587-593
    PubMedGoogle Scholar
  • 2 Gastpar M, Bonnet U, Böning J, Mann K, Schmidt L G, Soyka M, Wetterling T, Kielstein V, Labriola D, Croop R. Lack of efficacy of naltrexone in the prevention of alcohol relapse: results from a German multicenter study.  J Clin Psychopharmacol. 2002;  22 592-598
    Google Scholar
  • 3 Kiefer F, Jahn H, Schick M, Wiedemann K. Alcohol self-administration, craving and HPA-axis activity: an intriguing relationship.  Psychopharmacol. 2002;  164 239-240
    Google Scholar
  • 4 Kiefer F, Jahn H, Tarnaske T, Helwig H, Briken P, Holzbach R Stracke R, Naber D, Wiedemann K. Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study.  Arch Gen Psychiatry. 2003;  60 92-99
    Google Scholar
  • 5 Klein L C, Jamner L D, Alberts J, Orenstein M D, Levine L. Sex differences in salivary cortisol levels following naltrexone administration.  J Appl Biobehav Res. 2000;  5 144-153
    PubMedGoogle Scholar
  • 6 Krystal J H, Cramer J A, Krol W F, Kirk G F, Rosenheck R A. Naltrexone in the treatment of alcohol dependence.  N Engl J Med. 2001;  345 1734-1739
    Google Scholar
  • 7 O'Malley S S, Krishnan-Sarin S, Farren C, O'Connor P G. Naltrexone-induced nausea in patients treated for alcohol dependence: clinical predictors and evidence for opioid-mediated effects.  J Clin Psychopharmacol. 2000;  20 69-76
    CrossrefPubMedGoogle Scholar
  • 8 O'Malley S S, Krishnan-Sarin S, Farren C, Sinha R, Kreek J. Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis.  Psychopharmacol. 2002;  160 19-29
    PubMedGoogle Scholar
  • 9 Streeton C, Whelan G. Naltrexone, a relapse prevention maintenance treatment of alcohol dependence: a meta-analysis of randomized controlled trials.  Alcohol Alcohol. 2001;  36 544-552
    PubMedGoogle Scholar
  • 10 Zimmermann U, Spring K, Koller G, Holsboer F, Soyka M. Hypothalamic-pituitary-adrenal system regulation in recently detoxified alcoholics is not altered by one week of treatment with acamprosate.  Pharmacopsychiatry. 2004;  37 98-102
    Article in Thieme ConnectPubMedGoogle Scholar

Prof. Dr. Falk Kiefer

Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH) Mannheim

University of Heidelberg

Germany

Phone: +49 621 1703 3522

Fax: +49 621 1703 3505

Email: kiefer@zi-mannheim.de

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