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Megestrol attenuates hormonal response to CCK-4
Progestational hormones may have anxiolytic properties. CCK-4 (cholecystokinin tetrapeptide) can be used to pharmacologically induce panic attacks both in normal controls and patients suffering from panic disorder. In this study we sought to evaluate the effects of pre-treatment with the progestational hormone megestrol on CCK-4 induced panic and stress hormone release in male healthy controls.
Method: 10 medically and psychiatrically healthy male controls were pretreated with placebo or megestrol 160mg at 10 pm and 8 am (Σ=320mg) prior to the experiment and received an intravenous injection of 50µg of CCK-4.
Results: CCK-4 significantly increased anxiety and tension. Baseline ACTH-levels and cortisol-levels were significantly reduced after pre-treatment with megestrol.
Conclusion: Pre-treatment with megestrol has a profound effect on the HPA-axis activity and results in a significant reduction of both resting ACTH and cortisol as well as ACTH and cortisol after stimulation with CCK-4. These data support recent findings that synthetic progesterones exert neuroendocrine effects not only via progesterone receptors but also via glucocorticoid receptors.