Hypothalamic-pituitary-adrenal axis hypersensitivity to naloxone in opioid dependence: a case of naloxone-induced withdrawal
JA Culpepper-Morgan, MJ Kreek - Metabolism, 1997 - Elsevier
JA Culpepper-Morgan, MJ Kreek
Metabolism, 1997•ElsevierA case of opioid withdrawal precipitated in an opioid-dependent person by low plasma
levels of naloxone is presented. In this patient, changes were observed in the hypothalamic-
pituitary-adrenal (HPA) axis that preceded the clinical symptoms and adrenergic signs of
withdrawal. Plasma naloxone levels were strongly correlated with plasma cortisol levels (P<.
0001, R2=. 73, r=. 85). In addition, these neuroendocrine changes persisted after adrenergic
changes and clinical symptoms had been ameliorated by administration of a short-acting …
levels of naloxone is presented. In this patient, changes were observed in the hypothalamic-
pituitary-adrenal (HPA) axis that preceded the clinical symptoms and adrenergic signs of
withdrawal. Plasma naloxone levels were strongly correlated with plasma cortisol levels (P<.
0001, R2=. 73, r=. 85). In addition, these neuroendocrine changes persisted after adrenergic
changes and clinical symptoms had been ameliorated by administration of a short-acting …
A case of opioid withdrawal precipitated in an opioid-dependent person by low plasma levels of naloxone is presented. In this patient, changes were observed in the hypothalamic-pituitary-adrenal (HPA) axis that preceded the clinical symptoms and adrenergic signs of withdrawal. Plasma naloxone levels were strongly correlated with plasma cortisol levels (P < .0001, R2 = .73, r = .85). In addition, these neuroendocrine changes persisted after adrenergic changes and clinical symptoms had been ameliorated by administration of a short-acting opioid agonist. It is suggested that the HPA axis is a more sensitive indicator of opioid withdrawal than the adrenergic system.
Elsevier