1. Dear Drugs-Forum readers: We are a small non-profit that runs one of the most read drug information & addiction help websites in the world. We serve over 4 million readers per month, and have costs like all popular websites: servers, hosting, licenses and software. To protect our independence we do not run ads. We take no government funds. We run on donations which average $25. If everyone reading this would donate $5 then this fund raiser would be done in an hour. If Drugs-Forum is useful to you, take one minute to keep it online another year by donating whatever you can today. Donations are currently not sufficient to pay our bills and keep the site up. Your help is most welcome. Thank you.
    PLEASE HELP

Interdose elevation in plasma cortisol during chronic treatment with alprazolam but not lorazepam in

Interdose elevation in plasma cortisol during chronic treatment with alprazolam but not lorazepam in

  1. Jatelka
    Neuropsychopharmacology. 2004 Mar;29(3):605-11.

    Pomara N (http://www.ncbi.nlm.nih.gov/sites/e...bmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1), Willoughby LM (http://www.ncbi.nlm.nih.gov/sites/e...bmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1), Ritchie JC (http://www.ncbi.nlm.nih.gov/sites/e...bmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1), Sidtis JJ (http://www.ncbi.nlm.nih.gov/sites/e...bmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1), Greenblatt DJ (http://www.ncbi.nlm.nih.gov/sites/e...bmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1), Nemeroff CB (http://www.ncbi.nlm.nih.gov/sites/e...bmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1).

    Benzodiazepines (BZPs) have been shown to reduce hypothalamic-pituitary-adrenal (HPA) axis activity acutely in normal humans. In contrast, the effects of chronic BZP treatment on the HPA axis have not been well studied, especially in the geriatric population. This study examined the acute and chronic effects (3 weeks) of alprazolam and lorazepam on plasma cortisol in 68 subjects (60-83 years) who received 0.25 or 0.50 mg b.i.d. alprazolam, or 0.50 or 1.0 mg b.i.d. lorazepam, or placebo orally according to a randomized, double-blind, placebo-controlled parallel design. Memory assessment and blood samples for plasma cortisol were obtained prior to the morning dose on days 0, 7, 14, and 21, and at 1, 2.5, and 5 h postdrug on days 0 and 21. Assessments of anxiety and depression were carried out at days 0, 7, 14, and 21 before drug administration. Plasma cortisol was affected compared to placebo only by the 0.5 mg alprazolam dose. During the first and the last day of treatment, there was a significant drop in cortisol at 2.5 h after alprazolam compared to placebo. The predose cortisol levels increased significantly during chronic alprazolam treatment, and correlations were found between these cortisol changes and changes in depression, anxiety, and memory scores. These findings suggest that even a short period of chronic treatment with alprazolam, but not lorazepam, may result in interdose HPA axis activation in the elderly, consistent with drug withdrawal. If confirmed, this effect may contribute to an increased risk for drug escalation and dependence during chronic alprazolam treatment.

    Discussion Thread