Pharmacopsychiatry 2019; 52(01): 32-37
DOI: 10.1055/s-0043-124189
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Hypothalamic-Pituitary-Adrenocortical Axis Activity in Alcohol-Dependent Patients During Treatment with High-Dose Baclofen

Olga Geisel
1  Department of Psychiatry, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Ludwig Schlemm
2  Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
3  Berlin Institute of Health (BIH), Berlin, Germany
4  London School of Economics and Political Science, London, United Kingdom
,
Rainer Hellweg
1  Department of Psychiatry, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Klaus Wiedemann
5  Department of Psychiatry, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
,
Christian A. Müller
1  Department of Psychiatry, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
› Author Affiliations
Further Information

Publication History

received 02 August 2017
revised 22 November 2017

accepted 28 November 2017

Publication Date:
22 January 2018 (eFirst)

Abstract

Aims Activity of the hypothalamic-pituitary-adrenocortical (HPA) axis has been reported to be affected in alcohol use disorder (AUD). It has been suggested that pharmacological relapse prevention in AUD might exert its effects partly by modulation of HPA axis activity. Here, we assessed the effects of high-dose treatment with baclofen on HPA axis activity in alcohol-dependent patients within a 24-week randomized, placebo-controlled trial (BACLAD study).

Methods Plasma levels of copeptin, adrenocorticotropic hormone (ACTH), and cortisol were measured at 3 timepoints in alcohol-dependent patients during the study. Corresponding plasma levels in healthy controls were assessed once.

Results ACTH blood levels were significantly higher in the group of alcohol-dependent patients compared to controls. In patients receiving individually titrated high-dose baclofen, plasma cortisol levels decreased significantly, whereas no significant alterations were found in the placebo group.

Conclusions Our study underlines again the role of HPA axis alterations in AUD. Furthermore, a decrease in hormonal stress levels during treatment with high-dose baclofen might contribute to the relapse preventive effects of this compound.