Alcoholism :: Alcoholics should avoid excessive physical and psychological stress during early abstinence

The hypothalamic-pituitary-adrenal (HPA) axis defends against stress, starvation and illnesses. A new study shows “stunned” adrenocorticotropic hormone (ACTH) and cortisol secretion among alcoholic patients, reflecting changes in the HPA axis.

Scientists recommend that alcoholics avoid excessive stress ? both physical and psychological ? during early abstinence.

The hypothalamic-pituitary-adrenal (HPA) axis is a hormonal system that defends against stress, starvation and illnesses. New findings of alterations in adrenocorticotropic hormone (ACTH) and cortisol secretion in alcoholic patients, which reflect changes in the HPA axis, prompt recommendations that alcoholics avoid excessive stress ? both physical and psychological ? during early abstinence.

Results are published in the May issue of Alcoholism: Clinical & Experimental Research.

“The HPA axis provides the metabolic fuel for the reaction of the brain, muscles and heart against psychological and physical distress,” said Vittorio Coiro, aggregate professor in internal medicine at the University of Parma, Italy. “In previous research, tests with psychological and physical challenging stimuli ? such as operative traumata, hyperthermia, cold-pressor and public-speaking stress ? have shown a deficient HPA reactivity in abstinent alcoholics. However, none of these studies has established a time course of HPA failure during abstinence or has shown the time needed for a possible recovery.”

“The HPA axis is an exquisitely sensitive system triggered physiologically by a wide range of psychological and physical stressors,” remarked Cristiana Di Gennaro, research doctor at the University of Parma. “A rise in plasma ACTH and cortisol are considered good markers of stress, in terms of both acute reaction and of chronic exposure to stressful situations. An impaired function of HPA axis is well known in alcoholics,” she added, “and it has been suggested that a blunted HPA axis responsiveness plays a role in early alcohol relapse following detoxification in alcoholics.”


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