HPA axis function in alcohol use disorder: A systematic review and meta-analysis
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2023Access:
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Dunne, Neil, Ivers Jo-Hanna, HPA axis function in alcohol use disorder: A systematic review and meta-analysis, Addiction Neuroscience 8 (2023) 100114Download Item:
Abstract:
Alcohol use disorder (AUD) is a culturally pervasive and often treatment resistant disorder. Stress is a major trigger for relapse in AUD. Allostasis in response to stress
is governed by the hypothalamic-pituitary-adrenal axis (HPA axis). Investigation into HPA axis functioning in response to stress in AUD may provide a novel drug
target for AUD treatment. This systematic review found 46 studies concerning ongoing AUD, withdrawal from alcohol, early-abstinence (<6 months), and late-
abstinence (>6 months). Cortisol responses were mixed in ongoing AUD and higher in withdrawal. In early abstinence, significantly lower responses to stress
compared to healthy controls were found for ACTH (SMD = -1.47, p = < .001, I2: 35.68%) and cortisol (SMD = 1.32, p = < .001, I2: 38.97%). Baseline values did
not significantly differ compared to healthy controls for ACTH (SMD = 0.39, p = < .001, I2: 81.11%) and cortisol (SMD = 0.74, p = .015, I2: 88.66%). HPA axis
functionality may normalise following 6 months of abstinence, though this may be confounded by selection bias. HPA axis hypoactivity was associated with a higher
risk of relapse. Future research should aim to investigate all sexes and races, increase methodological consistency and participant follow up, and use HPA-sensitising
drugs during early abstinence to assess their effects on relapse rates. Overall, the HPA axis presents strong potential as a novel treatment target in AUD.
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http://people.tcd.ie/ndunne1http://people.tcd.ie/jivers
Author: Dunne, Neil; Ivers, Jo-Hanna
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Addiction Neuroscience;Availability:
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Neuroscience , ADDICTION , ALCOHOL , ALCOHOL DEPENDENCE , HYPOTHALAMICO-PITUITARY-ADRENAL (HPA) AXIS , NeuroscienceDOI:
https://doi.org/10.1016/j.addicn.2023.100114Metadata
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