https://scholars.lib.ntu.edu.tw/handle/123456789/582583
標題: | Chronic ketamine abuse is associated with orexin-A reduction and ACTH elevation | 作者: | Huang M.-C. Chen C.-H. LIAN-YU CHEN Chang H.-M. Chen C.-K. Lin S.-K. Xu K. |
關鍵字: | Abstinence; Adrenocorticotropic hormone (ACTH); Cortisol; Ketamine dependence; Orexin (hypocretin) | 公開日期: | 2020 | 出版社: | Springer | 卷: | 237 | 期: | 1 | 起(迄)頁: | 45-53 | 來源出版物: | Psychopharmacology | 摘要: | Background: Ketamine has emerged as a major substance of abuse worldwide. Evidence suggests a role of orexin system in reward processing, withdrawal, and stress response. It also interacts with the stress mechanisms of hypothalamic–pituitary–adrenal (HPA) axis to regulate drug-taking behavior. The study aimed to explore the relevance of orexin and stress hormones to chronic ketamine abuse. Methods: We enrolled 67 ketamine-dependent (KD) patients and 64 controls. The levels of orexin-A, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline, 1?week, and 2?weeks after ketamine discontinuation. KD patients were assessed by Beck Depression Inventory, Beck Anxiety Inventory, and Visual Analogue Scale for ketamine craving at baseline. Results: Compared with the controls, KD patients had significantly lower orexin-A (0.65 ± 0.12 vs. 0.74 ± 0.10?ng/mL, p < 0.001) and increased ACTH (32.3 ± 16.3 vs. 22.3 ± 11.0?pg/mL, p = 0.008) levels at baseline, whereas cortisol levels were similar between two groups. Levels of the three markers did not correlate with ketamine use variables, craving, depression, or anxiety symptoms. The levels did not alter after 1 or 2?weeks of ketamine discontinuation. Notably, those with higher anxiety had lower orexin-A but increased cortisol levels than did those with lower anxiety. Conclusions: This study showed that KD patients had persistent orexin-A reduction and stress hormone dysregulation in early abstinence. The anxious phenotype of KD might be associated with a lower orexin-A expression. These results point to a promising pathway to investigate the neurochemical mechanisms of ketamine addiction. ? 2019, Springer-Verlag GmbH Germany, part of Springer Nature. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85077666298&doi=10.1007%2fs00213-019-05342-9&partnerID=40&md5=5ef0f18ce9ac6138a1b2d002c4627067 https://scholars.lib.ntu.edu.tw/handle/123456789/582583 |
ISSN: | 0033-3158 | DOI: | 10.1007/s00213-019-05342-9 | SDG/關鍵字: | corticotropin; hydrocortisone; ketamine; orexin A; corticotropin; hydrocortisone; ketamine; orexin; adult; anxiety disorder; Article; Beck Anxiety Inventory; Beck Depression Inventory; controlled study; corticotropin blood level; depression; disease severity; drug craving; female; human; hydrocortisone blood level; hypothalamus hypophysis adrenal system; major clinical study; male; priority journal; protein blood level; visual analog scale; anxiety; case control study; craving; drug dependence; hypophysis adrenal system; hypothalamus hypophysis system; metabolism; middle aged; physiology; psychological rating scale; psychology; withdrawal syndrome; Adrenocorticotropic Hormone; Adult; Anxiety; Case-Control Studies; Craving; Depressive Disorder; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Ketamine; Male; Middle Aged; Orexins; Pituitary-Adrenal System; Psychiatric Status Rating Scales; Substance Withdrawal Syndrome; Substance-Related Disorders |
顯示於: | 流行病學與預防醫學研究所 |
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