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PubMed1995

Effects of dehydroepiandrosterone (DHEA) on pituitary prolactin and arcuate nucleus neuron tyrosine hydroxylase mRNA levels in the rat.

It is well documented that dehydroepiandrosterone (DHEA), an adrenal androgen, is converted into potent androgens and/or estrogens in peripheral tissues. Since sex steroids are involved in the regulation of prolactin (PRL) secretion, we have studied the effect of DHEA administration on PRL mRNA levels in both adult male and female rats. Since tuberoinfundibular dopaminergic (TIDA) neurons are involved in the negative regulation of PRL, we have also evaluated the effects of DHEA on the genetic expression of tyrosine hydroxylase (TH), the limiting enzyme in catecholamine biosynthesis in TIDA neurons. Sham-operated and castrated animals of both sexes received during 2 days DHEA at the dose of 6 mg/kg/day, starting on the first day after castration. PRL and TH mRNA levels were measured by quantitative in situ hybridization. In the male rat, orchiectomy performed 3 days earlier did not modify PRL mRNA levels. DHEA administration increased the hybridization signal in both sham-operated and orchiectomized animals. In the female, ovariectomy decreased PRL mRNA levels and, as observed in the male, DHEA treatment induced an increase in the hybridization signal in both control and ovariectomized rats. In TIDA neurons, castration increased TH mRNA levels as evaluated by number of grains over labelled neurons and the number of TH-labelled cells per section in both male and female animals. In both sham-operated male rats and orchiectomized animals, DHEA decreased the hybridization signal. In the female, DHEA administration completely prevented the increase in TH mRNA levels due to ovariectomy. In sham-operated female rats, the treatment had no effect. These data clearly indicate that in both male and female rats DHEA exerts an estrogenic influence on both PRL and TH gene expression. Although these in vivo experiments do not allow to establish whether the stimulation of PRL gene expression is due to an action of the steroid on the pituitary or at the hypothalamic level or alternatively at both sites, it is likely that one of the mechanisms of action of DHEA might be related to a decrease in dopamine release following a depression of TIDA neuron activity.

Animals↗

PubMed2006

DHEA enhances effects of weight training on muscle mass and strength in elderly women and men.

The plasma levels of dehydroepiandrosterone (DHEA) and its sulfated form (DHEAS) decline approximately 80% between the ages of 25 and 75 yr. Muscle mass and strength also decrease with aging. Published data on the effects of DHEA replacement on muscle mass and strength are conflicting. The goals of this study were to determine whether DHEA replacement increases muscle mass and strength and/or enhances the effects of heavy resistance exercise in elderly women and men. We conducted a randomized, double-blind, placebo-controlled study of the effects of 10 mo of DHEA replacement therapy with the addition of weightlifting exercise training during the last 4 mo of the study (DHEA + exercise group, n = 29; placebo + exercise group, n = 27). DHEA alone for 6 mo did not significantly increase strength or thigh muscle volume. However, DHEA therapy potentiated the effect of 4 mo of weightlifting training on muscle strength, evaluated by means of one-repetition maximum measurement and Cybex dynamometry, and on thigh muscle volume, measured by magnetic resonance imaging. Serum insulin-like growth factor concentration increased in response to DHEA replacement. This study provides evidence that DHEA replacement has the beneficial effect of enhancing the increases in muscle mass and strength induced by heavy resistance exercise in elderly individuals.

Adjuvants, Immunologic↗

PubMedDate not supplied

Dehydroepiandrosterone sulfate (DHEAS) secretion in early and advanced solid neoplasms: selective deficiency in metastatic disease.

Several endogenous hormones have been proven to stimulate cancer growth, whereas at present very few hormones are known to display oncostatic activity. The most widely investigated antitumor hormone is the pineal indole melatonin (MLT), and cancer progression has been shown to be associated with a decline in MLT secretion. Recently, another hormone, the adrenal steroid dehydroepiandrosterone-sulfate (DHEAS), has appeared to exert antitumor effects similar to those previously described for MLT. In addition, experimental studies suggest a diminished DHEAS production with neoplastic progression. This preliminary study was performed to evaluate the daily secretion of DHEAS in a group of early and advanced cancer patients. The study included 70 patients with solid tumors (gastrointestinal tract tumors: 28; breast cancer: 24; non-small cell lung cancer: 18), 28 without and 42 with distant metastases. The serum levels of DHEAS were measured by RIA in blood samples collected in the morning. The control group consisted of 100 age- and sex-matched healthy subjects. No significant difference in mean serum levels of DHEAS was observed between controls and non-metastatic patients. In contrast, metastatic patients, irrespectively of tumor histotype, showed significantly lower mean levels of DHEAS with respect to either controls or non-metastatic patients. Moreover, metastatic patients with visceral locations showed significantly lower values of DHEAS than those with bone or soft-tissue metastases. This preliminary study would suggest there to be a deficiency in the daily DHEA secretion in patients with disseminated cancer. Further studies evaluating circadian DHEAS secretion in relation in that of the pineal hormone MLT will be required to better define the biological significance of the advanced cancer-related decline in endogenous DHEAS production.

Adult↗

PubMed2006

Effect of DHEA-sulfate on adiponectin gene expression in adipose tissue from different fat depots in morbidly obese humans.

OBJECTIVE: A growing body of studies has demonstrated the inverse relationship between DHEA-sulfate (DHEA-S) and the pathological alterations associated with the metabolic syndrome. However, the mechanism by which DHEA-S treatment operates has not been elucidated completely. Adiponectin, an adipose-specific protein, is thought to have anti-diabetic and anti-atherosclerotic properties. Because fat depots differ in the impact of their relationship with the undesirable consequences of obesity, the aim of the present study was to investigate the effect of DHEA-S on adiponectin expression in both s.c. and visceral tissues in a morbidly obese population. DESIGN AND METHODS: We studied the in vitro expression of the adiponectin gene from paired biopsies of human visceral and s.c. adipose tissue, obtained from men and women (body mass index = 48.68+/- 7.43 kg/m2). Adipocytes were incubated for 24 h with or without DHEA-S. Adiponectin mRNA was measured by reverse transcription-quantitative PCR. RESULTS: In this population, DHEA-S plasma values were 141 +/- 105 microg/100 ml. Serum adiponectin values were under normal ranges. In basal conditions, s.c. tissue expressed higher amounts (58%) of adiponectin mRNA than visceral tissue (P = 0.027). Adiponectin expression was differentially regulated in the two depots by DHEA-S. There was a significant increase in adiponectin expression specifically in the visceral tissue (P = 0.020), but no significant effect of DHEA-S on the s.c. tissue (P = 0.738). CONCLUSIONS: In the present study, for the first time in humans, we have shown that DHEA-S treatment is a strong upregulator of adiponectin gene expression in omental adipocytes, suggesting that the positive effects observed by DHEA-S treatment in humans suffering from metabolic syndrome could be exerted through overexpression of adiponectin in the visceral depot.

Adipocytes↗

PubMed1984

Effect of genetic background on the therapeutic effects of dehydroepiandrosterone (DHEA) in diabetes-obesity mutants and in aged normal mice.

Dehydroepiandrosterone (DHEA) was fed at 0.1-0.4% in the diet to genetically diabetic (db/db) or obese (ob/ob) C57BL/KsJ (BL/Ks) or C57BL/6J (BL/6) mice. Treatment of BL/Ks-db/db or ob/ob mice with 0.4% DHEA prevented hyperglycemia, islet atrophy, and severe diabetes associated with this inbred background, but did not affect weight gain and food consumption. Homozygous obese (ob) or diabetes (db) mice on the BL/6 background were more sensitive to DHEA, and the mild, transient hyperglycemia associated with ob or db gene expression on the BL/6 inbred background could be prevented by 0.1% DHEA. Both body weight and food consumption were decreased in BL/6 mutants maintained on 0.1% DHEA whereas this effect was not seen in BL/Ks mutants fed up to 0.4% DHEA. Early therapy with 0.4% DHEA, initiated at 2 wk of age, prevented the development of most diabetes symptoms and decreased the rate of weight gain in pups of all genotypes. In addition to therapeutic effects on both obese mutants, DHEA effected significant changes in an aging study using normal BL/6 female mice. Four weeks of DHEA treatment initiated at 2 yr of age improved glucose tolerance and at the same time reduced plasma insulin to a "younger" level. This suggests that DHEA may act in insulin-resistant mutant mice and in aging normal mice to increase the sensitivity to insulin.

Aging↗

PubMed1999

The enhancement of hippocampal primed burst potentiation by dehydroepiandrosterone sulfate (DHEAS) is blocked by psychological stress.

This series of studies investigated the effects of psychological stress and the neurosteroid dehydroepiandrosterone sulfate (DHEAS) on hippocampal primed burst (PB) and long-term (LTP) potentiation, two electrophysiological models of memory. The DHEAS and stress manipulations were performed on awake rats, and then PB and LTP were recorded while the rats were anesthetized. DHEAS enhanced PB potentiation when administered to rats under non-stress conditions, but had no effect when given to stressed rats. Further study showed that DHEAS enhanced PB potentiation only when it was administered before, but not after, the rats were stressed. The DHEAS and stress manipulations had no effect on LTP. This study provides three major findings regarding stress, neurosteroids and hippocampal plasticity. First, DHEAS enhanced a threshold form of plasticity (PB potentiation), but had no effect on a supra-threshold form of plasticity (LTP). Second, stress blocked the DHEAS-induced enhancement of PB potentiation. Third, stress and DHEAS effects on the hippocampus were so durable they could be performed on awake animals and then be studied while the animals were anesthetized. That DHEAS enhanced a subset of forms of hippocampal plasticity under restricted behavioral conditions may help to resolve conflicting observations of DHEAS effects on cognition and mood in people.

Animals↗

PubMed1998

Modulation of cytokine production by dehydroepiandrosterone (DHEA) plus melatonin (MLT) supplementation of old mice.

Tissue levels of the antioxidants melatonin (MLT) and dehydroepiandrosterone (DHEA) decline with age, and this decline is correlated with immune dysfunction. The aim of the current study is to determine whether hormone supplementation with MLT and DHEA together would synergize to reverse immune senescence. Old (16.5 months) female C57BL/6 mice were treated with DHEA, MLT, or DHEA + MLT. As expected, splenocytes were significantly (P < 0.05) higher in old mice as compared to young mice. DHEA, MLT, and DHEA + MLT significantly (P < 0.005) increased B cell proliferation in young mice. However, only MLT and DHEA + MLT significantly (P < 0.05) increased B cell proliferation in old mice. DHEA, MLT, and DHEA + MLT help to regulate immune function in aged female C57BL/6 mice by significantly (P < 0.05) increasing Th1 cytokines, IL-2, and IFN-gamma or significantly (P < 0.05) decreasing Th2 cytokines, IL-6, and IL-10, thus regulating cytokine production. DHEA and MLT effectively modulate suppressed Th1 cytokine and elevated Th2 cytokine production; however, their combined use produced only a limited additive effect.

Animals↗

PubMed2002

DHEA: the last elixir.

(1) DHEA, or dehydroepiandrosterone, is an adrenal steroid. Its physiological role is unclear, but it is known to be an intermediate in sex hormone synthesis. DHEA replacement therapy is not currently indicated in adrenal insufficiency. (2) Plasma DHEA levels are so low in most animal species that they are difficult to measure, hindering studies of the impact of DHEA on ageing. Most animal studies are based on administration of pharmacological doses. (3) Clinical data have been obtained in a very large number of observational studies, in which plasma concentrations of DHEA were measured in various situations. The only established fact is that circulating concentrations show wide interpersonal variability and a tendency to fall with age. Low DHEA levels have not so far been linked to any specific health disorders. (4) Clinical trials of DHEA have focused on cognitive function, well-being, libido, immunostimulation, etc. There is no proof that DHEA is beneficial in these areas. (5) The side effects of DHEA are linked to its androgenic effects (acne, hirsutism), its unfavourable effects on lipid metabolism (a cardiovascular risk factor), and a possible growth-stimulating effect on hormone-dependent malignancies (prostate, breast). (6) In practice, there is currently no scientific reason to prescribe DHEA for any purpose whatsoever.

Adjuvants, Immunologic↗

PubMed2006

[DHEA inhibits apoptosis of murine OB through MAPK signaling pathways independent of either ARs or ERs].

Dehydroepiandrosterone (DHEA) is a promising agent for the treatment of post-menopausal osteoporosis (PMO), but the molecular mechanisms and signaling pathways by which this steroid modulates apoptosis of osteoblasts (OB) are still poorly understood. In this study,the OBs were cultured in vitro by the enzyme-digested method,treated with DHEA (10(-7) mol/L) for 0h, 24h, 48h, 72h, respectively. The expressions of ER alpha, ER beta and AR mRNA in OB were analyzed by RT-PCR. After the primary OBs were deprived of serum for a further 24h, and then pretreated with 1 micromol/L ICI 182,780 (an estrogen receptor antagonist), 10 micromol/L Flutamide (an androgen receptor antagonist) or 100 micromol/L U0126 (a specific inhibitor of MAPK pathway) for 1h, they were treated with a series of concentrations of DHEA (10(-10) - 10(-5) mol/L) in serum-free medium for 72h,the apoptotic cells were analyzed by FCM with the Annexin-V-FITC/PI dual labeling technique. The OBs were incubated in 1 micromol/L ICI 182,780 or 10 micromol/L Flutamide for 25 minutes,and then treated with different concentrations of DHEA for the further 10 minutes. The phosphorylation status of ERK1/2 was analyzed by Western blot. After the OBs were incubated with DHEA (10(-7)mol/L) for 24h, 48h or 72h, respectively, its ERbeta and AR mRNA level were increased (P<0.05, P<0.01, respectively), but the ER alpha mRNA level had no change. The 10(-9) - 10(-6) mol/L of DHEA inhibited OBs early apoptosis induced by the serum deprivation (P<0.05, P<0.01, respectively). The inhibiting effect, moreover, could be blocked by the specific inhibitor of MAPK pathway, U0126. The effects of DHEA were neither blocked by the steroid hormone antagonist ICI 182,780 nor by Flutamide. Western blot showed that neither receptor antagonist ICI 182,780 nor Flutamide could block the DHEA-induced ERKs phosphorylation in OBs,which was similar to the apoptosis. DHEA inhibits apoptosis in OBs presumably via a DHEA-specific receptor that involves mitogen activated protein kinase (MAPK) signal pathway, phospho-pERK1/2, independent of either ARs or ERs.

Animals↗

PubMed1997

TCPL delivery system: the role of DHT, DHEA, and E on the epididymal tubules of adult male rats.

Recent studies reported from our laboratory have established that the sustained delivery of danazol in combination with androgens resulted in the remarkable reduction of epididymal mass. In addition, previous studies have recommended that ultrastructural of epididymal tubules have to be elucidated. The specific objective of this investigation was to evaluate the cytological characteristics of epididymal tissues exposed to sustained delivery of dihydrotestosterone (DHT), dehydroepiandrsterone (DHEA) and a combination of Estrogen (E), DHEA plus DHT by means of tricalcium phosphate lysine (TCPL) delivery system. Adult male rats (BW 300-350 gm) were randomly divided into four equal groups: Group I animals were implanted i.p. with TCPL loaded with DHEA (100 mg). Animals in group II were implanted with TCPL capsules loaded with DHEA (100 mg) + DHT (500 mg). Group III animals were implanted with TCPL capsules loaded with E (200 mg) + DHEA (100 mg) + DHT (500 mg). Group IV animals served as the intact unimplanted controls. Surgical aseptic techniques were performed according to standard laboratory procedures. The animals were maintained at the University of Mississippi Medical Center Animal Facilities following the rules and regulations established by NIH on the Care and Use of Laboratory animals. At the end of 6 weeks post implantation, all animals were sacrificed and the epididymal tissues were collected, weighed, and embedded for histopathological evaluations. Statistical analysis was conducted by using standard computer programs (STATVIEW, ANOVA at 95% CI). The data obtained in this investigation demonstrated the following: (1) remarkable reduction in sperm counts and motility obtained from epididymal tubules in all experimental (hormonally treated) groups, (2) the lumen of the epididymal tubules were devoid of sperm in animals treated with DHT in comparison to the control, (3) a decrease in the diameter of tubules with occasional hypertrophic epithelium in all experimental animals, (4) disorganization of nuclear material was observed in animals treated with DHEA and DHEA + E + DHT in comparison to the control group. The overall observation of this study suggests that sustained delivery of DHEA, DHEA + DHT, and DHEA + DHT + E can be used to regulate the structural and functional architecture of the site of extramaturation of spermatozoa.

Animals↗

PubMed2005

Effects of DHEA administration on episodic memory, cortisol and mood in healthy young men: a double-blind, placebo-controlled study.

RATIONALE: Dehydroepiandrosterone (DHEA) has been reported to enhance cognition in rodents, although there are inconsistent findings in humans. OBJECTIVES: The aim of this study was to investigate the effects of DHEA administration in healthy young men on episodic memory and its neural correlates utilising an event-related potential (ERP) technique. METHODS: Twenty-four healthy young men were treated with a 7-day course of oral DHEA (150 mg b.d.) or placebo in a double blind, random, crossover and balanced order design. Subjective mood and memory were measured using visual analogue scales (VASs). Cortisol concentrations were measured in saliva samples. ERPs were recorded during retrieval in an episodic memory test. Low-resolution brain electromagnetic tomography (LORETA) was used to identify brain regions involved in the cognitive task. RESULTS: DHEA administration led to a reduction in evening cortisol concentrations and improved VAS mood and memory. Recollection accuracy in the episodic memory test was significantly improved following DHEA administration. LORETA revealed significant hippocampal activation associated with successful episodic memory retrieval following placebo. DHEA modified ERPs associated with retrieval and led to a trend towards an early differential activation of the anterior cingulate cortex (ACC). CONCLUSIONS: DHEA treatment improved memory recollection and mood and decreased trough cortisol levels. The effect of DHEA appears to be via neuronal recruitment of the steroid sensitive ACC that may be involved in pre-hippocampal memory processing. These findings are distinctive, being the first to show such beneficial effects of DHEA on memory in healthy young men.

Adolescent↗

PubMed1995

Effects of dehydroepiandrosterone (DHEA) on GnRH gene expression in the rat brain as studied by in situ hybridization.

Dehydroepiandrosterone (DHEA) is an adrenal androgen that is converted into potent androgens and/or estrogens in peripheral tissues. To further investigate the potential role of DHEA in reproductive functions in the rat, we have studied the effect of 2-day administration of DHEA on GnRH gene expression in brain of sham-operated and castrated animals of both sexes. In the male rat, orchiectomy induced an increase in the hybridization signal. In sham-operated animals, DHEA decreased GnRH mRNA levels induced by orchiectomy. In orchiectomized rats, DHEA also depressed the amount of mRNA levels and then reversed the increase in mRNA levels induced by orchiectomy. In female animals, as observed in the male, castration produced an increase in the hybridization signal. In both sham-operated and ovariectomized animals, DHEA administration increased mRNA levels. These data clearly indicate that DHEA administration can modify neuronal GnRH gene expression in adult rats of both sexes, the effect being inhibitory in the male and stimulating in the female. This modulation of GnRH neuronal activity, which is probably exerted following the conversion of DHEA into active sex steroids, might be at least partly responsible for modifications of the activity of the hypothalamo-pituitary-gonadal axis induced by DHEA.

Animals↗

PubMed2005

Aging and season affect plasma dehydroepiandrosterone sulfate (DHEA-S) levels in a primate.

In humans, plasma concentration of dehydroepiandrosterone sulfate (DHEA-S) declines with age and is considered as a potential predictor of longevity. DHEA-S is apparently unique to primates but few species of nonhuman primates have been studied for age-related changes in DHEA-S. In a short living primate, the grey mouse lemur (longevity 10-13 years), metabolic and physiological parameters exhibit high seasonal changes with age-related decrease in amplitude. From 8 month- to 11-year-old males (N = 175), plasma DHEA-S levels were measured either during the breeding season or during the winter sexual rest. Plasma DHEA-S levels show high significant changes according to season and age. During winter, DHEA-S levels were maintained low and constant over lifetime. During the summer breeding season, a decline of DHEA-S levels occurred after the age of 3 years and accelerated after the age of 6 years. DHEA-S level was about 30-40% of its adult value with age over 6 years, a stepwise pattern most closely resembling to human pattern. In mouse lemur, DHEA-S met the criteria for a biomarker of aging. When correlated to other age-related changes, the results give the opportunity to consider the mouse lemur as a promising primate model to study aging processes.

Aging↗

PubMed2006

Dehydroepiandrosterone (DHEA) treatment stimulates oxidative energy metabolism in the cerebral mitochondria from developing rats.

Effects of treatment with dehydroepiandrosterone (DHEA) (0.2 or 1.0mg/kg body weight for 7 days) on oxidative energy metabolism in cerebral mitochondria from developing and young adult rats were examined. Treatment with DHEA did not change the body weight of developing rats but resulted in increase in the brain weight in 5 week group. In young adult rats the body weight increased following treatment with 1.0mg DHEA. State 3 and state 4 respiration rates with all the substrates increased following DHEA treatment, the effect being more pronounced in the developing rats. State 4 respiration rates were stimulated to variable extents. Contents of cytochromes aa(3) and b increased following DHEA treatment and once again the effect was more pronounced in the developing rats. DHEA treatment marginally changed the content of cytochromes c+c(1). In the developing rats the ATPase activity and the levels of dehydrogenases increased significantly by DHEA treatment. Results of our studies have shown that treatment with exogenous DHEA accelerates the process of maturation of cerebral mitochondria thus emphasizing the role of DHEA in brain development in postnatal life.

Animals↗

PubMed2005

DHEA improves symptomatic treatment of moderately and severely impaired MPTP monkeys.

The steroid dehydroepiandrosterone (DHEA) is abundant in men and women and decreases rapidly during aging. Parkinson's disease (PD) is the second most common neurodegenerative disorder just behind Alzheimer. l-3,4-Dihydroxyphenylalanine (l-Dopa) therapy remains the most effective treatment but many patients develop motor complications. This study investigated the acute effect of DHEA alone and with l-Dopa in 12 females monkeys lesioned with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to model PD. DHEA administration alone improved the mean parkinsonian score at 1, 5 and 15mg/kg in moderately and severely impaired MPTP monkeys and increased blood DHEA concentrations. DHEA with a low dose of l-Dopa increased the l-Dopa effect in moderately and severely impaired MPTP monkeys. DHEA lengthened duration of the effect of the low dose of l-Dopa by 15-45min. DHEA at 1, 5 and 15mg/kg combined with a high dose of l-Dopa did not increase dyskinesias. DHEA could act by reducing inhibitory GABAergic activity in the striatal output pathways. DHEA could also be metabolized into estradiol in the brain and increase acutely dopamine activity.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

PubMed2006

Chronic DHEAS administration facilitates hippocampal long-term potentiation via an amplification of Src-dependent NMDA receptor signaling.

Dehydroepiandrosterone sulfate (DHEAS) has well characterized effects on memory and cognitive performances. Recently we have reported that repetitive administration of DHEAS lowers the threshold pulse number in inducing activity-dependent long-term potentiation (LTP) in rat hippocampal Schaffer collateral-CA1 synapses, in which a sub-threshold high frequency stimulation (HFS, 30 pulses at 100 Hz) for normal rats could induce robust LTP in DHEAS-treated rats (Chen et al., 2006). Here we report that the sub-threshold HFS could trigger the phosphorylation of Src and ERK2 in the DHEAS-treated rats, but not in control rats. We found in slices obtained from the DHEAS-treated rats that NMDA-induced intracellular Ca2+([Ca2+]i) transients in CA1 pyramidal neurons were significantly potentiated, which was essential for the Src and ERK2 phosphorylations. The activation of ERK2, a downstream factor of Src family kinase, was required for the DHEAS-facilitated LTP. The Src family kinase inhibitor PP2, but not its inactive homologue PP3, attenuated the NMDA-induced [Ca2+]i increase and abolished the DHEAS-facilitated LTP. These findings suggest that the chronic administration of DHEAS brings the NMDA receptor (NMDAr) to a potentiated state that causes an enough level of [Ca2+]i increase for LTP induction even by the sub-threshold HFS. The potentiated [Ca2+]i transient by the sub-threshold HFS may trigger the Src phosphorylation that will further potentiate NMDAr followed by an activation of ERK2 and LTP induction. This novel postsynaptic NMDAr/Src-mediated signal amplification through "NMDAr-Ca2+-->Src-->NMDAr-Ca2+" cycle may play a pivotal role in the DHEAS-facilitated LTP induction.

Analysis of Variance↗

PubMed2005

DHEAS and POMS measures identify cocaine dependence treatment outcome.

UNLABELLED: Early attrition is a significant problem in the treatment of cocaine dependence, but it is unclear why some patients succeed in treatment while others relapse or drop out of treatment without a demonstrated relapse. The goal of this study was to determine whether baseline levels of select hormones, including the adrenal hormone and excitatory neurosteroid dehydroepiandrosterone sulfate (DHEAS), would distinguish between treatment outcome groups. Based on the literature, completion of 90 days of treatment was established as a key outcome variable. METHODS: Quantitative urine levels of the cocaine metabolite benzoylecgonine (BE) and other substance of abuse analytes, plasma levels of DHEAS, DHEA, cortisol, and prolactin, and the profile of mood states (POMS) were serially measured in 38 male cocaine-dependent (DSM-IV) patients and in 28 controls of similar gender and age over a six month study. Exclusion criteria for the patients and controls included Axis I mood, anxiety or psychotic disorders. The patients could not manifest substance dependence except to cocaine. The patients and controls received remuneration for urine and blood collection. Blood samples for hormone levels were obtained between 8 and 10 a.m. on days 1, 14 and 21 of a 21-day inpatient treatment program and throughout 6 months of outpatient study visits at 45-day intervals. RESULTS: Attrition from treatment and study appointments occurred predominately at the junction between inpatient and outpatient programs. Forty percent of patients made the transition to outpatient treatment and remained abstinent and in treatment for a median of 103 days (ABST). Forty-two percent of patients dropped out of treatment during the inpatient stay or never returned after completing the inpatient program (DO) and 18% had a documented relapse either during, or within the first week after, the inpatient stay (REL). POMS total scores were elevated at treatment entry for both the ABST and DO groups. Plasma DHEAS levels in the DO patients were decreased compared to controls and increased in the ABST patients. POMS total scores for the REL patients at baseline were at control levels. Baseline cortisol levels were not statistically different between the outcome groups, though they were elevated for all cocaine patient groups. When treatment outcome was collapsed into whether patients completed (ABST) or did not complete 90 days of treatment (90N), ABST plasma DHEAS and cortisol were significantly elevated compared to the 90N patients and controls across the first 3 weeks of cocaine withdrawal. CONCLUSIONS: At treatment entry, each of the three patient outcome groups was identified by levels of circulating DHEAS and distressed mood. In the ABST patients, distressed mood during withdrawal may have been mitigated through antidepressant-like actions of enhanced endogenous DHEAS activity, thus contributing to improved abstinence and treatment retention. Patients, such as the DO group, with high levels of distressed mood at treatment entry and low DHEAS levels may benefit from adjunctive pharmacotherapy that targets DHEAS and POMS measures. Patients, such as the REL group, who lack distressed mood at treatment entry, may require intense application of motivational approaches plus residential treatment.

Adult↗

PubMed2005

The diurnal patterns of the adrenal steroids cortisol and dehydroepiandrosterone (DHEA) in relation to awakening.

The steroid hormones, cortisol and dehydroepiandrosterone (DHEA) are the two main peripheral secretory products of the hypothalamic-pituitary-adrenal stress-neuroendocrine axis. The diurnal pattern of cortisol secretory activity has been well characterised. Various aspects of this pattern have been related to time of awakening, light exposure, psychological dimensions of affect, immune function and systemic health and well-being. DHEA is also an important adrenocortical steroid whose secretory activity has been related to immune function, psychological and health variables. The most pronounced feature of the diurnal cortisol cycle is a burst of secretory activity following awakening with a diurnal decline thereafter. We mapped DHEA secretory activity onto this cycle by measuring both steroids in saliva samples collected at distinct time points over the diurnal cycle, synchronised to awakening. Both steroids, particularly DHEA, showed stability across days of sample collection. A main distinction between cortisol and DHEA was that although DHEA was elevated in post-awakening samples compared with later in the day there was no evidence of an awakening stimulatory burst of DHEA secretory activity. Although DHEA in many respects paralleled cortisol secretory activity there was some dissociation; mean levels were positively but not tightly correlated. The secretory pattern of DHEA is very stable whereas cortisol secretory activity seems more sensitive to day-to-day variability.

Adolescent↗