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Wang JX, Fu L, Lei Q, Zhuang JY. Ovarian hormones predict cooperative strategies updating during multiple rounds of the prisoner's dilemma. Acta Psychol (Amst) 2024; 247:104307. [PMID: 38759584 DOI: 10.1016/j.actpsy.2024.104307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
Increasing research has focused on how ovarian hormones influence individual prosocial motivation and cooperation. However, most results remain ambiguous and contradictory. Here, we collected progesterone (PROG) and oestradiol from 62 healthy women with regular menstrual cycles to explore whether variations in ovarian hormones could flexibly change their cooperative preference according to their opponents' strategies in multiple rounds of a prisoner's dilemma (PD) game. Participants in different menstrual phases (32 in the follicular phase [FP] and 30 in the luteal phase [LP]) were asked to complete 20 rounds of PD games with each of three computer opponents holding different cooperative strategies. The results revealed that in PD games that did not require cooperation for increased outcomes, women in the LP (high PROG) reduced their cooperation rate more significantly than women in the FP (low PROG). In contrast, when the game design required reciprocity, simultaneously elevated levels of PROG and oestradiol predicted greater instances of participants choosing to cooperate. Furthermore, we found that elevated PROG levels accounted for women's elevated prosocial choices, regardless of the need to increase outcomes through cooperation. These results implied higher levels of PROG and oestradiol influence women's cooperative strategies resulting in increased social interactions.
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Affiliation(s)
- Jia-Xi Wang
- Mental Health Education Center, Beijing Technology and Business University, Beijing 100048, China.
| | - Lulu Fu
- Department of Psychology, East China Normal University, Shanghai 200062, China
| | - Qin Lei
- Department of Psychology, East China Normal University, Shanghai 200062, China
| | - Jin-Ying Zhuang
- Department of Psychology, East China Normal University, Shanghai 200062, China.
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2
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Macatee RJ, Cannon MJ, Schermitzler BS, Preston TJ, Afshar K. Biological sex and hormonal contraceptive associations with drug cue reactivity in cannabis use disorder. J Psychiatr Res 2024; 174:121-128. [PMID: 38626562 PMCID: PMC11195151 DOI: 10.1016/j.jpsychires.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/18/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024]
Abstract
Biological sex differences in Cannabis Use Disorder (CUD) progression, cannabis withdrawal severity, and pharmacotherapy response have been reported, suggesting that CUD mechanisms may differ by sex. Drug cue reactivity is an established predictor of drug use behavior, but the literature on sex differences in drug cue reactivity is mixed, including in CUD. One possible moderator of sex differences in drug cue reactivity is hormonal contraceptive (HC) use. The aim of the present study was to test whether sex differences in neural cannabis cue reactivity and craving varied by female HC use in a CUD sample. As part of a larger study, 152 adults reporting frequent cannabis use completed a drug cue reactivity task during electrocenphalogram recording. Late positive potential (LPP) amplitude modulation by cannabis cues was used to measure neural cue reactivity. Craving after the cue reactivity task was also assessed. Males (n = 74) and naturally-cycling females (n = 26), who did not differ from each other, showed significantly greater LPP enhancement to cannabis vs. neutral cues compared to HC-using females (n = 52), an effect mostly driven by neutral cues. Craving was significantly higher in naturally-cycling but not HC-using females compared to males, but only in covariate-unadjusted analyses. Exploratory analyses of HC and menstrual phase characteristics indicate a progesterone-related mechanism may underlie HC effects on cannabis cue reactivity. The present study's results suggest that mixed findings on drug cue reactivity sex differences may be due to variability in HC use, which has implications for sex-specific models of CUD progression and treatment.
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Affiliation(s)
| | | | | | | | - Kaveh Afshar
- Auburn University, Department of Psychological Sciences, USA
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3
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Peltier MR, Verplaetse TL, Altemus M, Zakiniaeiz Y, Ralevski EA, Mineur YS, Gueorguieva R, Picciotto MR, Cosgrove KP, Petrakis I, McKee SA. The role of neurosteroids in posttraumatic stress disorder and alcohol use disorder: A review of 10 years of clinical literature and treatment implications. Front Neuroendocrinol 2024; 73:101119. [PMID: 38184208 PMCID: PMC11185997 DOI: 10.1016/j.yfrne.2023.101119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/08/2023] [Accepted: 12/31/2023] [Indexed: 01/08/2024]
Abstract
Rates of alcohol use disorder (AUD) are increasing in men and women and there are high rates of concurrent posttraumatic stress disorder (PTSD) and AUD. AUD and PTSD synergistically increase symptomatology and negatively affect treatment outcomes; however, there are very limited pharmacological treatments for PTSD/AUD. Neurosteroids have been implicated in the underlying neurobiological mechanisms of both PTSD and AUD and may be a target for treatment development. This review details the past ten years of research on pregnenolone, progesterone, allopregnanolone, pregnanolone, estradiol, testosterone and dehydroepiandrosterone/dehydroepiandrosterone-sulfate (DHEA/DHEA-S) in the context of PTSD and AUD, including examination of trauma/alcohol-related variables, such as stress-reactivity. Emerging evidence that exogenous pregnenolone, progesterone, and allopregnanolone may be promising, novel interventions is also discussed. Specific emphasis is placed on examining the application of sex as a biological variable in this body of literature, given that women are more susceptible to both PTSD diagnoses and stress-related alcohol consumption.
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Affiliation(s)
- MacKenzie R Peltier
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA.
| | | | - Margaret Altemus
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA
| | - Yasmin Zakiniaeiz
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Elizabeth A Ralevski
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA
| | - Yann S Mineur
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Ralitza Gueorguieva
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
| | - Marina R Picciotto
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Kelly P Cosgrove
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA; Department of Radiology and Biomedical Imaging, School of Medicine, Yale University, New Haven, CT, USA
| | - Ismene Petrakis
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA
| | - Sherry A McKee
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
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Eng AG, Nirjar U, Elkins AR, Sizemore YJ, Monticello KN, Petersen MK, Miller SA, Barone J, Eisenlohr-Moul TA, Martel MM. Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Horm Behav 2024; 158:105466. [PMID: 38039899 PMCID: PMC10872410 DOI: 10.1016/j.yhbeh.2023.105466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/14/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that exhibits striking sex differences in symptoms, prevalence, and associated problems across development. Etiological factors and mechanisms underlying these sex differences remain one of the most understudied aspects of this disorder. The current paper seeks to provide a novel theoretical framework for understanding this phenomenon by reviewing evidence that females with ADHD may experience a "double whammy" of organizational and activational pubertal hormonal effects. We propose a novel theory of activational effects of cyclical circulating ovarian hormones on ADHD with increasing risk at times of rapid declines in estrogen. These declines may decrease executive function and trait control at two points of the cycle characterized by biphasic affective risk: (1) increases in approach/risk-taking behaviors at mid-cycle (periovulatory) and (2) increases in avoidance/negative affect perimenstrually. Low estrogen and control may then interact with increases in positive and negative affect, respectively, to increase hyperactivity-impulsivity symptoms post-ovulation and inattention symptoms perimenstrually. These interactions may be exacerbated by organizational pubertal effects on relatively overdeveloped limbic circuitry and adolescent-specific social pressures magnified in females with ADHD.
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Affiliation(s)
- Ashley G Eng
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America.
| | - Urveesha Nirjar
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Anjeli R Elkins
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Yancey J Sizemore
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Krystina N Monticello
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Madeline K Petersen
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Sarah A Miller
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Jordan Barone
- University of Illinois Chicago at Chicago College of Medicine, Department of Psychiatry, 912 S. Wood St, Chicago, IL 60612, United States of America
| | - Tory A Eisenlohr-Moul
- University of Illinois Chicago at Chicago College of Medicine, Department of Psychiatry, 912 S. Wood St, Chicago, IL 60612, United States of America
| | - Michelle M Martel
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
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Ralevski E, Newcomb J, Pisani E, DeNegre D, Peltier M, Jane JS, Yoon G, Petrakis I. Progesterone Attenuates the Stress Response in Individuals with Alcohol Dependence and Post-Traumatic Stress Disorder - A Pilot Study. J Dual Diagn 2024; 20:39-51. [PMID: 38147491 DOI: 10.1080/15504263.2023.2294989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE Evidence from laboratory studies suggests that progesterone may be effective in reducing stress and craving, and may improve cognitive performance in smokers and individuals with cocaine dependence. The objective of this study was to examine if progesterone would attenuate stress-induced craving, anxiety, affect and physiological measures, as well as improve stress-induced cognitive performance (processing speed and selective attention) in individuals diagnosed with alcohol use disorder (AUD) and post traumatic stress disorder (PTSD). METHODS This laboratory study included (n = 13) participants who were diagnosed with current AUD and PTSD who were randomly assigned to recive either progesterone (200mg bid) or placebo in identical looking capsules for 3 days. On the fourth day they completed a laboratory session. In the morning of the test session, they received the last dose of medication and completed the rest of the laboratory procedures. The procedures included presentation in random order of personalized trauma and neutral scripts with relaxation in between. Main outcomes included measure of craving, anxiety, affect and cognitive performance. RESULTS Consistent with other research, trauma scripts produced significantly greater increases in craving, anxiety and negative affect when compared with neutral scripts. Progesterone significantly reduced stress-induced symptoms of craving, anxiety, fear, anger and sadness but had no effect on positive emotions (joy, relaxation). Progesterone was effective in ameliorating stress-induced decreases in cognitive performance. CONCLUSIONS The findings from this study demonstrate that progesterone can be effective in reducing stress-induced craving, anxiety and negative affect in a laboratory setting in individuals with comorbid AUD and PTSD. Interestingly, progesterone also improved cognitive performance. These findings require replication in a larger clinical trial and may have implications for treatment among individuals with AUD and PTSD.This study was registered as NCT02187224, at www.clinicaltrials.gov.
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Affiliation(s)
- Elizabeth Ralevski
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Mental Illness Research and Clinical Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Jenelle Newcomb
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Emily Pisani
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Diana DeNegre
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Mental Illness Research and Clinical Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - MacKenzie Peltier
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Jane Serrita Jane
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Gihyun Yoon
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Mental Illness Research and Clinical Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Ismene Petrakis
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Mental Illness Research and Clinical Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
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Farris SG, Smith JE, Steinberg DR, Altman BR, Lambert-Messerlian GM, Dunsiger SI, Williams DM, Saladin ME, Abrantes AM. Methodological approach for an integrated female-specific study of anxiety and smoking comorbidity. Front Psychiatry 2023; 14:1267753. [PMID: 38076702 PMCID: PMC10704195 DOI: 10.3389/fpsyt.2023.1267753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/08/2023] [Indexed: 02/12/2024] Open
Abstract
Two primary ovarian hormones that fluctuate across the female menstrual cycle-estradiol and progesterone-have been independently linked in separate literatures to nicotine reinforcement and anxiety psychopathology. We identify existing methodological limitations in these literatures, describe an example protocol that was developed to address such limitations, highlight case examples, and offer insights on the resulting advantages and challenges. This protocol was an observational, prospective, within-subjects study of female cigarette smokers who were followed over the course of a complete menstrual cycle. Non-treatment seeking, female cigarette smokers (N = 50), between the ages of 18-40 who have a normal menstrual cycle (25-35 days in length) were recruited from the community. Females with anxiety or mood psychopathology represented 38.0% of the sample. Salivary progesterone and estradiol were assessed each morning via at-home saliva collection methods. Self-reported within-day momentary ratings of anxiety and nicotine reinforcement were collected using ecological momentary assessment (EMA) via a mobile app. Protocol compliance was >85%. Within- and between-subjects heterogeneity was observed in the progesterone and estradiol, anxiety, and nicotine craving measures, especially in the context of anxiety psychopathology. We aimed to integrate the anxiety and nicotine dependence literatures and advance the empirical study of the role of ovarian hormones. This protocol reflects an intensive, yet feasible approach to collecting daily-level naturalistic data related to estradiol, progesterone, anxiety, and nicotine reinforcement.
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Affiliation(s)
- Samantha G. Farris
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Jacqueline E. Smith
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Dana R. Steinberg
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Brianna R. Altman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Geralyn M. Lambert-Messerlian
- Pathology and Laboratory Medicine and Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, United States
| | - Shira I. Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Michael E. Saladin
- Department of Health Science and Research, Medical University of South Carolina, Charleston, SC, United States
| | - Ana M. Abrantes
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, United States
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Peltier MR, McKee SA. The role of sex hormones in targeting stress-induced tobacco craving, stress-reactivity, and smoking with guanfacine among women who smoke. ADDICTION NEUROSCIENCE 2023; 7:100084. [PMID: 37396408 PMCID: PMC10311966 DOI: 10.1016/j.addicn.2023.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Women who smoke are particularly vulnerable to tobacco craving, smoking behaviors, and relapse in the context of stress when compared to men who smoke. One factor in this sex difference may be sex hormones, including estradiol and progesterone; however, smoking cessation medication trials often do not explore the impact of sex hormones on drug effects. This secondary analysis of a double-blind, placebo-controlled study explored the impact of levels of actual estradiol and progesterone on guanfacine, a noradrenergic α2a agonist, which attenuates stress-induced smoking behaviors in women. Women who smoke (n = 43) completed a stress induction laboratory paradigm followed by an ad-libitum smoking period. Assessment of tobacco craving, and stress-reactivity (via cortisol response) occurred pre- and post-stress induction. Results indicated that guanfacine attenuated stress-induced tobacco craving (F = 10.94, p = 0.02) and cortisol response (F = 14.23, p < 0.001); however, high levels of estradiol overrode guanfacine's effect on craving (F = 4.00, p = 0.05), cortisol response (F = 14.23, p < 0.001), and smoking during the ad-libitum period (F = 12.23, p = 0.001). Additionally, progesterone proved to be protective against tobacco craving and enhanced guanfacine's medication effect on craving (F = 5.57, p = 0.02). The present study found that sex hormones had a significant impact on medication effects in a smoking cessation trial and thus underscore the importance of examining the role of sex hormones in future medication trials.
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Affiliation(s)
- MacKenzie R. Peltier
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 109, Yale School of Medicine, New Haven, CT 06519, USA
- Psychology Service, VA Connecticut Healthcare System West Haven, CT 06516, USA
| | - Sherry A. McKee
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 109, Yale School of Medicine, New Haven, CT 06519, USA
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Maher EE, Strzelecki AM, Weafer JJ, Gipson CD. The importance of translationally evaluating steroid hormone contributions to substance use. Front Neuroendocrinol 2023; 69:101059. [PMID: 36758769 PMCID: PMC10182261 DOI: 10.1016/j.yfrne.2023.101059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/22/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
Clinically, women appear to be more susceptible to certain aspects of substance use disorders (SUDs). The steroid hormones 17β-estradiol (E2) and progesterone (Pg) have been linked to women-specific drug behaviors. Here, we review clinical and preclinical studies investigating how cycling ovarian hormones affect nicotine-, cocaine-, and opioid-related behaviors. We also highlight gaps in the literature regarding how synthetic steroid hormone use may influence drug-related behaviors. In addition, we explore how E2 and Pg are known to interact in brain reward pathways and provide evidence of how these interactions may influence drug-related behaviors. The synthesis of this review demonstrates the critical need to study women-specific factors that may influence aspects of SUDs, which may play important roles in addiction processes in a sex-specific fashion. It is important to understand factors that impact women's health and may be key to moving the field forward toward more efficacious and individualized treatment strategies.
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Affiliation(s)
- Erin E Maher
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Ashley M Strzelecki
- Department of Psychology, University of Kentucky, Lexington, KY, United States
| | - Jessica J Weafer
- Department of Psychology, University of Kentucky, Lexington, KY, United States
| | - Cassandra D Gipson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States.
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Fox HC, Milivojevic V, Sinha R. Therapeutics for Substance-Using Women: The Need to Elucidate Sex-Specific Targets for Better-Tailored Treatments. Handb Exp Pharmacol 2023; 282:127-161. [PMID: 37592081 DOI: 10.1007/164_2023_687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
In the last decade, alcohol consumption in the US has risen by 84% in women compared with 35% in men. Furthermore, research has shown that sex- and gender-related differences may disadvantage women in terms of developing a range of psychological, cognitive, and medical problems considerably earlier in their drinking history than men, and despite consuming a similar quantity of substances. While this "telescoping" process has been acknowledged in the literature, a concomitant understanding of the underlying biobehavioral mechanisms, and an increase in the development of specific treatments tailored to women, has not occurred. In the current chapter we focus on understanding why the need for personalized, sex-specific medications is imperative, and highlight some of the potential sex-specific gonadal and stress-related adaptations underpinning the accelerated progress from controlled to compulsive drug and alcohol seeking in women. We additionally discuss the efficacy of these mechanisms as novel targets for medications development, using exogenous progesterone and guanfacine as examples. Finally, we assess some of the challenges faced and progress made in terms of developing innovative medications in women. We suggest that agents such as exogenous progesterone and adrenergic medications, such as guanfacine, may provide some efficacy in terms of attenuating stress-induced craving for several substances, as well as improving the ability to emotionally regulate in the face of stress, preferentially in women. However, to fully leverage the potential of these therapeutics in substance-using women, greater focus needs to the placed on reducing barriers to treatment and research by encouraging women into clinical trials.
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Affiliation(s)
- Helen C Fox
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Verica Milivojevic
- The Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- The Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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10
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Novick AM, Duffy KA, Johnson RL, Sammel MD, Cao W, Strasser AA, Sofuoglu M, Kuzma A, Loughead J, Epperson CN. Progesterone Increases Nicotine Withdrawal and Anxiety in Male but Not Female Smokers During Brief Abstinence. Nicotine Tob Res 2022; 24:1898-1905. [PMID: 35713950 PMCID: PMC9653080 DOI: 10.1093/ntr/ntac146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/08/2022] [Accepted: 06/14/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Although exogenous progesterone may hold promise as a treatment for nicotine use disorders, it is unclear whether it is similarly effective in males and females. This study examined the effects of progesterone on nicotine use disorder comprehensively using behavioral, psychological, and neural measures in male and female smokers exposed to brief abstinence. AIMS AND METHODS Thirty-three male and 33 female non-treatment-seeking smokers participated in a double-blind, randomized, placebo-controlled crossover study of 200 mg of progesterone or placebo daily over a four-day abstinence period. Smoking behavior and subjective effects of nicotine were assessed at baseline and after final drug administration. Nicotine withdrawal, smoking urges, mood states, and neural response to smoking cues were measured at baseline, after the first drug administration, and after the final drug administration. RESULTS No main effect of drug (progesterone vs. placebo) emerged for any outcome. Significant sex by drug interactions emerged for nicotine withdrawal (p = .020), perceived strength of nicotine (p = .040), and perceived bad effects of nicotine (p = .029). Males receiving progesterone reported worse nicotine withdrawal (p = .046) and a trend towards decreased bad effects of nicotine (p = .070). Males on progesterone also reported greater tension and anxiety relative to placebo (p = .021). Females on progesterone perceived nicotine's effects as being stronger relative to placebo (p = .046). CONCLUSIONS Progesterone causes sex-dependent effects on smoking-related outcomes during brief abstinence. Specifically, progesterone in males may increase rather than decrease nicotine withdrawal and negative affect during abstinence, potentially hindering efforts to quit smoking. IMPLICATIONS In male and female smokers undergoing a brief period of abstinence, we examined the effects of progesterone on smoking outcomes. While progesterone had limited effects in female smokers, in males, it worsened nicotine withdrawal and negative affect. Our findings emphasize the importance of analyzing sex differences in future studies examining progesterone as a potential treatment and suggest that progesterone in males could potentially exacerbate aspects of nicotine dependence. CLINICALTRIALS.GOV REGISTRATION NCT01954966. https://clinicaltrials.gov/ct2/show/NCT01954966.
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Affiliation(s)
- Andrew M Novick
- Corresponding Author: Andrew M. Novick, MD, PhD, Department of Psychiatry, University of Colorado-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA. Telephone: 303-724-5656; Fax: 844-886-1892; E-mail:
| | - Korrina A Duffy
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Mary D Sammel
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Wen Cao
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Alexandra Kuzma
- Larner College of Medicine, University of Vermont, Burlington, VM, USA
| | - James Loughead
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Neill Epperson
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Family Medicine, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Novick AM, Duffy KA, Johnson RL, Sammel MD, Cao W, Strasser AA, Sofuoglu M, Kuzma A, Loughead J, Morrow AL, Epperson CN. Effect of progesterone administration in male and female smokers on nicotine withdrawal and neural response to smoking cues: role of progesterone conversion to allopregnanolone. Biol Sex Differ 2022; 13:60. [PMID: 36274158 PMCID: PMC9590190 DOI: 10.1186/s13293-022-00472-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/15/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Progesterone administration has therapeutic effects in tobacco use disorder (TUD), with females benefiting more than males. Conversion of progesterone to the neurosteroid allopregnanolone is hypothesized to partly underlie the therapeutic effects of progesterone; however, this has not been investigated clinically. METHODS Smokers (n = 18 males, n = 21 females) participated in a randomized, double-blind, placebo-controlled crossover study of 200 mg progesterone daily across 4 days of abstinence. The ratio of allopregnanolone:progesterone was analyzed in relationship to nicotine withdrawal, smoking urges, mood states, subjective nicotine effects, and neural response to smoking cues. RESULTS Allopregnanolone:progesterone ratio interacted with sex to predict withdrawal symptoms (p = 0.047), such that females with higher allopregnanolone:progesterone ratios reported lower withdrawal severity (b = - 0.98 [- 1.95, - 0.01]; p = 0.048). In addition, allopregnanolone:progesterone ratio interacted with sex to predict confusion (p = 0.014) and fatigue (p = 0.034), such that females with higher allopregnanolone:progesterone ratios reported less confusion (b = - 0.45 [- 0.78, - 0.12]; p = 0.008) and marginally lower fatigue (b = - 0.50 [- 1.03, 0.02]; p = 0.062. Irrespective of sex, higher ratios of allopregnanolone:progesterone were associated with stronger "good effects" of nicotine (b = 8.39 [2.58, 14.20]); p = 0.005) and weaker "bad effects" of nicotine (b = - 7.13 [- 13.53, - 0.73]; p = 0.029). CONCLUSIONS Conversion of progesterone to allopregnanolone correlated with smoking-related outcomes in both sex-dependent and sex-independent ways. Sex-dependent effects suggest that conversion of progesterone to allopregnanolone may contribute to greater therapeutic benefits in females but not males with TUD. Trial registration Clinicaltrials.gov registration, retrospectively registered: NCT01954966; https://clinicaltrials.gov/ct2/show/NCT01954966 \.
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Affiliation(s)
- Andrew M Novick
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA.
| | - Korrina A Duffy
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of CO-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Mary D Sammel
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of CO-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Wen Cao
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, 06511, USA
| | - Alexandra Kuzma
- Larner College of Medicine, University of Vermont, Burlington, VM, 05405, USA
| | - James Loughead
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - A Leslie Morrow
- Departments of Psychiatry and Pharmacology and the Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA
| | - C Neill Epperson
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Family Medicine, School of Medicine, University of CO-Anschutz Medical Campus, Aurora, CO, 80045, USA
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12
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Tronson NC, Schuh KM. Hormonal contraceptives, stress, and the brain: The critical need for animal models. Front Neuroendocrinol 2022; 67:101035. [PMID: 36075276 DOI: 10.1016/j.yfrne.2022.101035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 01/10/2023]
Abstract
Hormonal contraceptives are among the most important health and economic developments in the 20thCentury, providing unprecedented reproductive control and a range of health benefits including decreased premenstrual symptoms and protections against various cancers. Hormonal contraceptives modulate neural function and stress responsivity. These changes are usually innocuous or even beneficial, including their effects onmood. However, in approximately 4-10% of users, or up to 30 million people at any given time, hormonal contraceptives trigger depression or anxiety symptoms. How hormonal contraceptives contribute to these responses and who is at risk for adverse outcomes remain unknown. In this paper, we discussstudies of hormonal contraceptive use in humans and describe the ways in which laboratory animal models of contraceptive hormone exposure will be an essential tool for expanding findings to understand the precise mechanisms by which hormonal contraceptives influence the brain, stress responses, and depression risk.
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Affiliation(s)
- Natalie C Tronson
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Kristen M Schuh
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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13
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Oliva A, Reed SC, Brooks DJ, Levin FR, Evans SM. Safety and tolerability of progesterone treatment for women with cocaine use disorder: a pilot treatment trial. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:586-595. [PMID: 36095308 DOI: 10.1080/00952990.2022.2114004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: Problematic cocaine use remains a significant public health issue, particularly among women. However, no concerted efforts have been made to target a pharmacological treatment option for women with cocaine use disorder (CUD) despite preclinical, human laboratory, and a limited number of clinical studies demonstrating that progesterone can attenuate the effects of cocaine to a greater extent in women than men.Objectives: To evaluate the safety, tolerability, and preliminary efficacy of progesterone for treating women with CUD.Methods: A 10-week double-blind randomized treatment trial was conducted. Prior to randomization, participants were required to achieve cocaine abstinence (1 week) before assignment to progesterone (up to 400 mg/day) or placebo. The primary efficacy outcomes were days to relapse and cocaine abstinence during the last 3 weeks of the trial. The frequency of side effects was also assessed.Results: 227 women were assessed for eligibility. Twenty-five women entered treatment and 21 were randomized to progesterone (n = 11) or placebo (n = 10). The majority of women relapsed in less than 4 days with no differences between the two groups. Further, there were no significant differences between the progesterone and placebo groups in terms of cocaine abstinence during the last 3 weeks of the trial (27% and 10% respectively). The most commonly reported side effects were headache and fatigue, but no group differences were noted.Conclusions: Progesterone was well tolerated and safe and supports further study is in a larger sample to determine if exogenous progesterone is an effective treatment option for women with CUD.(ClinicalTrials.gov Identifier: NCT00632099).
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Affiliation(s)
- Alyssa Oliva
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - Stephanie C Reed
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Daniel J Brooks
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - Frances R Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Suzette M Evans
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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14
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Schwartz EKC, Wolkowicz NR, De Aquino JP, MacLean RR, Sofuoglu M. Cocaine Use Disorder (CUD): Current Clinical Perspectives. Subst Abuse Rehabil 2022; 13:25-46. [PMID: 36093428 PMCID: PMC9451050 DOI: 10.2147/sar.s337338] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
Cocaine use disorder (CUD) is a devastating disorder, impacting both individuals and society. Individuals with CUD face many barriers in accessing treatment for CUD, and most individuals with CUD never receive treatment. In this review, we provide an overview of CUD, including risk factors for CUD, common co-occurring disorders, acute and chronic effects of cocaine use, and currently available pharmacological and behavioral treatments. There are no FDA-approved pharmacological treatments for CUD. Future studies with larger sample sizes and testing treatment combinations are warranted. However, individuals with CUD and co-occurring disorders (eg, a mood or anxiety disorder) may benefit from medication treatments. There are behavioral interventions that have demonstrated efficacy in treating CUD – contingency management (CM) and cognitive-behavioral therapy for substance use disorders (CBT-SUD) in particular – however many barriers remain in delivering these treatments to patients. Following the discussion of current treatments, we highlight some promising emerging treatments, as well as offer a framework that can be used in building a treatment plan for individuals with CUD.
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Affiliation(s)
- Elizabeth K C Schwartz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
- Correspondence: Elizabeth KC Schwartz, Tel +1-203-932-5711, Fax +1-203-937-3472, Email
| | - Noah R Wolkowicz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joao P De Aquino
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - R Ross MacLean
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
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15
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Gueorguieva R, Schwartz EKC, MacLean RR, DeVito EE, Eid T, Wu R, O’Malley SS, Sofuoglu M. Plasma Menthol Glucuronide as a Biomarker for the Behavioral Effects of Menthol and Nicotine in Humans. Front Pharmacol 2022; 13:844824. [PMID: 35431934 PMCID: PMC9009207 DOI: 10.3389/fphar.2022.844824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
This secondary analysis sought to determine if plasma menthol glucuronide (MG) concentrations predict changes in three outcomes, subjective drug effects, urges to smoke, and heart rate, following concurrent inhaled menthol and intravenous nicotine. A total of 45 menthol and non-menthol cigarettes smokers (36 male, nine female, 20 Black, and 23 White) were included in this double-blind, placebo-controlled study. Across three test sessions, participants were assigned to a different flavor condition for each session: 0% (no menthol), 0.5%, or 3.2% menthol. In each test session, participants received in a random order one intravenous delivery of saline and two intravenous deliveries of nicotine (0.25 mg/70 kg and 0.5 mg/70 kg), each 1 h apart, concurrent with menthol delivery by e-cigarettes. The main outcomes were subjective drug effects, urges to smoke, and heart rate. The results showed that following e-cigarette inhalation, changes in plasma MG concentrations or “menthol boost” increased proportionally to the menthol concentration in the e-liquids. While changes in plasma MG concentrations were not predictive of increases in heart rate or subjective drug effects that are reflective of acute effects from nicotine (i.e., feel good effects, stimulated, aversive effects), they were predictive of cooling effect, a typical effect of menthol, but only in menthol smokers in the absence of concurrent active nicotine infusion. These findings demonstrate the utility of plasma MG as a biomarker both for acute menthol exposure by e-cigarette inhalation and for the examination of the concentration-dependent behavioral and physiological effects of menthol in humans.
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Affiliation(s)
- Ralitza Gueorguieva
- Yale School of Public Health, Department of Biostatistics, New Haven, CT, United States
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
| | - Elizabeth K. C. Schwartz
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
- VA Connecticut Healthcare System, West Haven, CT, United States
| | - R. Ross MacLean
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
- VA Connecticut Healthcare System, West Haven, CT, United States
| | - Elise E. DeVito
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
| | - Tore Eid
- Yale University, School of Medicine, Department of Laboratory Medicine, New Haven, CT, United States
| | - Ran Wu
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
| | - Stephanie S. O’Malley
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
| | - Mehmet Sofuoglu
- Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, United States
- VA Connecticut Healthcare System, West Haven, CT, United States
- *Correspondence: Mehmet Sofuoglu,
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16
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Abstract
LEARNING OBJECTIVE After participating in this activity, learners should be better able to:• Discuss and outline the general and overlapping effects of the menstrual cycle on women's mental health. ABSTRACT A growing body of research demonstrates menstrual cycle-dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women's mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.
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17
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Jao NC, Gueorguieva R, Hitsman B, Sofuoglu M. Acute effects of inhaled menthol on cognitive effects of intravenous nicotine among young adult cigarette smokers. Addict Behav 2021; 122:107022. [PMID: 34174551 DOI: 10.1016/j.addbeh.2021.107022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/14/2022]
Abstract
Basic science studies indicate that menthol can enhance the cognitive effects of nicotine to increase nicotine dependence; however, the effect of menthol and nicotine on cognitive functioning among humans has been understudied. This double-blind, placebo-controlled study examined the dose-dependent effects of inhaled menthol flavoring and intravenous nicotine on cognitive task performance. Twenty menthol (MS) and 18 non-menthol (NMS) cigarette preferring, young-adult smokers (21% female; 7.9% Hispanic, 44.7% Non-Hispanic/White, 47.4% Non-Hispanic/Black) completed three sessions with randomized order of menthol flavoring (between-sessions: 0.0%/tobacco control, 0.5%/low, 3.2%/high) and intravenous nicotine (within-session: 0.0 mg/saline control, 0.25 mg/low, 0.5 mg/high). After each administration, participants completed three cognitive tasks: Continuous Performance Task (CPT), Mathematical Processing Task (MPT), and Stroop Task. Mixed effects models were used to examine interactive effects of cigarette type preference and menthol and nicotine doses. MS vs. NMS had decreased accuracy on CPT and MPT and efficiency during Stroop. No significant effects of cigarette type preference by menthol or nicotine were found for any task. Significant effects of nicotine by menthol were found during Stroop, where participants had greater accuracy for high nicotine compared to saline during the low menthol session. Significant effects of menthol by timepoint were seen during Stroop, where participants improved across timepoints during the low menthol session. Findings did not support significant effects of inhaled menthol, alone or with nicotine, on cognitive performance. Further research clarifying the impact of varying menthol and nicotine levels in nicotine products may help to elucidate menthol's role in smoking sustainment.
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18
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Baker NL, Gray KM, Ramakrishnan V, Tomko RL, McClure EA, Carpenter MJ, Saladin ME. Increases in endogenous progesterone attenuate smoking in a cohort of nontreatment seeking women: An exploratory prospective study. Addict Biol 2021; 26:e12918. [PMID: 32476209 DOI: 10.1111/adb.12918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/28/2020] [Accepted: 05/03/2020] [Indexed: 12/16/2022]
Abstract
Despite advances in prevention and treatment, cigarette smoking remains a leading cause of preventable death in the United States. Although men and women are equally likely to attempt to quit smoking cigarettes, women are far less likely to achieve abstinence both during and following cessation treatment. Recent evidence suggests that ovarian hormone levels may play a role in successful abstinence attempts in women smokers. The primary goal of this exploratory prospective observational study was to estimate the association between within-participant levels of progesterone and estradiol with associated cigarettes smoked per day in adult women smokers (n = 104). The primary study outcome was self-reported cigarettes smoked per day (CPD) during a 2-week observational period collected using a daily smoking diary. Additionally, participants collected saliva daily, from which hormone levels (progesterone and estradiol) were derived. Higher within-participant progesterone levels were associated with a significant decrease in CPD (p = .008) whereas within-participant estradiol levels were unrelated to CPD (p = .25). Regression models indicated a single change in the trajectory of smoking behavior for both within-participant progesterone and estradiol. When progesterone values were below the change point, there was a significant inverse relationship between within-participant progesterone levels and smoking behavior (p = .025) whereas the relationship was attenuated for higher within-participant progesterone levels (p = .59). The effect of estradiol on smoking behavior was not significant when it was either below (p = .92) or above (p = .16) the change point. Higher within-participant levels of progesterone but not estradiol are associated with reduced CPD in nontreatment seeking women smokers.
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Affiliation(s)
- Nathaniel L. Baker
- Department Public Health Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
- Youth Division, Department of Psychiatry and Behavioral Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
| | - Viswanathan Ramakrishnan
- Department Public Health Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
| | - Rachel L. Tomko
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
| | - Erin A. McClure
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
- Hollings Cancer Center Medical University of South Carolina (MUSC) Charleston South Carolina USA
| | - Michael E. Saladin
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina (MUSC) Charleston South Carolina USA
- Department of Health Sciences and Research Medical University of South Carolina (MUSC) Charleston South Carolina USA
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19
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Carroll ME, Zlebnik NE, Holtz NA. Preference for Palatable Food, Impulsivity, and Relation to Drug Addiction in Rats. NEUROMETHODS 2021. [DOI: 10.1007/978-1-0716-0924-8_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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20
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Nobile B, Maimoun L, Jaussent ID, Seneque M, Dupuis-Maurin K, Lefebvre P, Courtet P, Renard E, Guillaume S. Effects of Hormonal Contraception Use on Cognitive Functions in Patients With Bulimia Nervosa. Front Psychiatry 2021; 12:658182. [PMID: 34079484 PMCID: PMC8165222 DOI: 10.3389/fpsyt.2021.658182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Growing evidences indicate that sex hormones have an effect on cognitive functions, and that Bulimia Nervosa (BN) is associated with cognitive impairment. The aim of this study was to determine the effect of hormonal contraception (HC) use on four cognitive functions that are impaired in patients with BN. Methods: This retrospective exploratory study included 103 women with a diagnosis of BN based on the DSM-5 criteria. Their age ranged from 15 to 45 years, and 46.6% were taking HC (oral, transdermal, or intrauterine). Cognition was assessed with the d2 test (attention), Iowa gambling task (IGT; decision making), Brixton spatial anticipation test (set shifting), and Rey-Osterrieth complex figure test (central coherence). Data were analyzed with logistic regression models to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of HC effect on the neuropsychological test scores. Results: In the multivariate model, HC use was significantly associated with better scores for two d2 test indices: F-score [OR = 0.98, 95% CI = (0.95; 0.99)] and final total score ratio [OR = 0.87, 95% CI = (0.77; 0.99)]. HC was also associated with a better understanding of the IGT explicit rules. No difference between the two groups (HC and non-HC use) was detected for set shifting and central coherence. Conclusions: This exploratory study suggests that HC could have effects on the sustained attention and concentration in women with BN. More studies are needed to confirm these results.
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Affiliation(s)
- Benedicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Laurent Maimoun
- Department of Nuclear Medicine, CHRU Montpellier, Montpellier, France.,INSERM U1046, UMR9214 CNRS, Physiology and Experimental Medicine of the Heart and Muscles, University of Montpellier, CHRU Montpellier, Montpellier, France
| | | | - Maude Seneque
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France
| | - Kathlyne Dupuis-Maurin
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France
| | - Phillippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France.,UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
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21
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Allen A, Mallahan S, Ortega A, Miller H, Saleh A, Bonny AE. Administration of Exogenous Hormones and the Implications for Cigarette Smoking-Related Behaviors. Curr Psychiatry Rep 2020; 22:70. [PMID: 33089443 DOI: 10.1007/s11920-020-01197-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Preclinical evidence indicates progesterone and estrogen influence drug-taking behaviors, including nicotine/tobacco. However, clinical research on this relationship is less clear. This lack of clarity may be due to measuring naturally occurring endogenous hormones to examine this relationship, which introduces substantial error. Therefore, the goal of this review is to examine the link between the delivery of exogenous hormones and cigarette smoking-related behavior. RECENT FINDINGS Exogenous progesterone may have favorable effects on cognition, symptomatology, consumption, and smoking cessation. Hormonal replacement therapy does not have a clear relationship with smoking-related behaviors. Oral contraceptive use may have adverse effects on stress response, nicotine metabolism, and symptomatology. Additional research is needed to explore how the administration of exogenous hormones may (a) strengthen research methodology on this topic, (b) enhance our understanding of the role of progesterone/estrogen on smoking-related behaviors, and (c) improve smoking cessation outcomes.
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Affiliation(s)
- Alicia Allen
- Department of Family and Community Medicine, College of Medicine, Tucson, University of Arizona, Tucson, AZ, 85721, USA.
| | - Stephanie Mallahan
- Department of Family and Community Medicine, College of Medicine, Tucson, University of Arizona, Tucson, AZ, 85721, USA
| | - Alexis Ortega
- Office of Equity, Diversity, and Inclusion, Health Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Heather Miller
- Department of Obstetrics and Gynecology, College of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Ahlam Saleh
- Health Sciences Library, University Libraries, University of Arizona, Tucson, AZ, 85721, USA
| | - Andrea E Bonny
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, OH, 43215, USA
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22
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Wang JX, Zhuang JY, Fu L, Lei Q, Fan M, Zhang W. How ovarian hormones influence the behavioral activation and inhibition system through the dopamine pathway. PLoS One 2020; 15:e0237032. [PMID: 32790683 PMCID: PMC7425921 DOI: 10.1371/journal.pone.0237032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/18/2020] [Indexed: 11/19/2022] Open
Abstract
The behavioral activation system (BAS) and the behavioral inhibition system (BIS) have been proposed to relate to stable traits that predict inter-individual differences in motivation. Prior reports point dopamine (DA) pathways, mainly including ventral tegmental area (VTA) and substantia nigra (SN), implicate in subserving reward-related functions associated with BAS and inhibitory functions related with BIS. However, as an important factor that affects DA releasing, it remains an open question whether the ovarian hormones may also be related to BIS/BAS. Here, to investigate effects of the estradiol (E2) and progesterone (PROG) on BIS/BAS and related DA pathways, we employed a BIS/BAS scale and the resting-state functional magnetic resonance imaging (fMRI) during the late follicular phase (FP) and the mid-luteal phase (LP). On the behavioral level, when women had high PROG levels, their E2 levels were found positively correlated with BIS scores, but those women whose PROG levels were low, their E2 levels were negative correlation with BIS scores. On the neural level, we demonstrated BAS was related with the VTA pathway, included brain reward regions of nucleus accumbens (NAc) and orbitofrontal cortex (OFC). Meanwhile, the BIS was correlated with the SN-dorsolateral prefrontal cortex (dlPFC) pathway. ROI-based resting-state functional connectivity (RSFC) analyses further revealed that, RSFC between the SN and dlPFC was modulated by ovarian hormones. With higher PROG levels, increased E2 levels among women were accompanied by stronger RSFC of the SN-dlPFC, but when PROG levels were low, E2 levels were negatively correlated with the SN-dlPFC RSFC. These findings revealed a combined enhancement effect of E2 and PROG on BIS, and the SN-dlPFC pathway was mainly involved in this process.
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Affiliation(s)
- Jia-Xi Wang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Jin-Ying Zhuang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Lulu Fu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Qin Lei
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Mingxia Fan
- Department of Physics, Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Weidong Zhang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
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Sherman BJ, Baker NL, Brady KT, Joseph JE, Nunn LM, McRae-Clark A. The effect of oxytocin, gender, and ovarian hormones on stress reactivity in individuals with cocaine use disorder. Psychopharmacology (Berl) 2020; 237:2031-2042. [PMID: 32388622 PMCID: PMC8210538 DOI: 10.1007/s00213-020-05516-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/01/2020] [Indexed: 12/22/2022]
Abstract
RATIONALE Cocaine use disorder (CUD) is associated with dysregulation of the hypothalamic-pituitary-adrenal axis, which plays a critical role in the human stress response. Men and women with CUD differ in reactivity to social stressors. The hypothalamic neuropeptide oxytocin is involved in anxiolytic and natural reward processes, and has shown therapeutic potential for addictive disorders and stress reduction. OBJECTIVES To examine the impact of oxytocin (oxytocin (OXY) vs. placebo (PBO)) and gender (female (F) vs. male (M)) on response to a social stress task in individuals with CUD. To explore whether ovarian hormones moderate this stress response. METHODS One hundred twelve adults with CUD were randomized to receive 40 IU intranasal oxytocin (n = 56) or matching placebo (n = 56). Forty minutes after drug administration, participants were exposed to a social stressor. Generalized linear mixed models were used to examine neuroendocrine (cortisol) and subjective (craving, stress) response at pre-stressor, stressor + 0, + 10, + 30, + 60 min. RESULTS Gender moderated the effect of oxytocin on neuroendocrine response (p = 0.048); women receiving oxytocin (F + OXY) showed blunted cortisol response compared to the other three groups (F + PBO; M + OXY; M + PBO). There was a main effect of gender on subjective stress response; women reported greater stress following the stressor compared to men (p = 0.016). Oxytocin had no significant effect on craving or stress, and gender did not moderate the effect of oxytocin on either measure. Higher endogenous progesterone was associated with lower craving response in women (p = 0.033). CONCLUSIONS Oxytocin may have differential effects in men and women with CUD. Women may be at greater risk for relapse in response to social stressors, but ovarian hormones may attenuate this effect.
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Affiliation(s)
- Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, USA
| | - Lisa M Nunn
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Allen S, Petersen A, Harrison K, Tosun N, Cameron J. Response to nicotine following overnight smoking abstinence during short-term progesterone treatment in women. Exp Clin Psychopharmacol 2020; 28:306-316. [PMID: 31464476 PMCID: PMC7048655 DOI: 10.1037/pha0000312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preclinical and clinical literature suggest that sex hormones impact tobacco use behaviors in women. The goal of this double-blind crossover laboratory study was to examine the effect of oral exogenous progesterone (200 mg twice per day) versus placebo on nicotine response using measures of motor speed and cognitive function in women following overnight smoking abstinence. We hypothesized that increased progesterone would blunt the nicotine response whereby producing less change in motor speed and cognition in response to nicotine exposure. Female smokers, age 18-35, were randomized to participate in two 9-day crossover testing weeks. Participants completed a lab session following overnight abstinence where they were administered nicotine nasal spray and asked to complete measures of immediate memory (IMT), delayed memory (DMT), word recall (WR), and finger tapping speed (FT). After the first 9-day testing week, participants resumed smoking and returned the following month to complete the identical lab session in the crossover condition. Forty-seven women were included in this analysis (n = 47). We found no differences in the magnitude of response for IMT, DMT, and WR between conditions. For FT, women had a blunted response to nicotine during the placebo condition. When examining the association between hormone levels and relative performance, we found increases in DMT, WR, and FT but decreases in IMT during the progesterone condition. We observed differences between progesterone versus placebo in relative change in some measures of nicotine response following overnight abstinence. Future studies are needed to further characterize this response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Sharon Allen
- Department of Family Medicine & Community Health, University of Minnesota 516 Delaware Street SE, Minneapolis, MN 55455
| | - Ashley Petersen
- Division of Biostatistics, School of Public Health, University of Minnesota 420 Delaware Street SE, Minneapolis, MN 55455
| | - Katherine Harrison
- Department of Family Medicine & Community Health, University of Minnesota 717 Delaware Street SE, Minneapolis, MN 55414
| | - Nicole Tosun
- Department of Family Medicine & Community Health, University of Minnesota 717 Delaware Street SE, Minneapolis, MN 55414
| | - Jacquelyn Cameron
- William Beaumont School of Medicine, Oakland University 586 Pioneer Dr, Rochester, MI 48309
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Harrison K, Petersen A, Tosun N, Crist K, Allen AM, Allene S. Effect of exogenous progesterone administration on cigarette smoking-related symptomology in oral contraceptive users who smoke. Addict Behav 2020; 102:106148. [PMID: 31706140 DOI: 10.1016/j.addbeh.2019.106148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/02/2019] [Accepted: 09/25/2019] [Indexed: 12/29/2022]
Abstract
Cigarette smoking-related symptomatology (e.g., craving; SRS) is linked to relapse after a quit attempt. SRS varies by menstrual phase, possibly due to variations in sex hormones (e.g., progesterone), though much of the research to-date has relied on observations from the menstrual cycle acting as a proxy for hormone levels. The goal of this study was to examine the effect of exogenous progesterone on SRS during ad libitum smoking and following overnight abstinence. Oral contraceptive users who smoked completed two 9-day crossover testing periods (7 days of ad libitum smoking and 2 days following overnight abstinence) while taking double-blind active/placebo exogenous progesterone. Participants completed questionnaires to measure SRS. The effect of exogenous progesterone and endogenous hormones (progesterone, estradiol, and progesterone-to-estradiol [P/E2] ratio) on SRS was assessed with paired t-tests and linear mixed effect models. Participants (n = 53) were, on average, 24 years old and smoked 11 cigarettes per day. During ad libitum smoking, a doubling of the P/E2 ratio was associated with 0.09 points lower anticipated relief from negative affect (95% confidence interval [CI]: 0.03-0.15 points lower; p = 0.008) and 0.11 points lower psychological reward (95% CI: 0.03-0.18 points lower; p = 0.006). After correction for multiple testing, these associations were not statistically significant: anticipated relief from negative effect (p = 0.10) and psychological reward (p = 0.09). No other significant associations were observed. Although substantial previous literature indicates that progesterone influences SRS, exogenous progesterone administration did not alter SRS here. Additional research is needed to elucidate alternative mechanisms involved in menstrual phase effects on SRS.
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Affiliation(s)
- Katherine Harrison
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 261, Minneapolis, MN 55414, United States.
| | - Ashley Petersen
- Division of Biostatistics, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, United States.
| | - Nicole Tosun
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 261, Minneapolis, MN 55414, United States.
| | - Katherine Crist
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 261, Minneapolis, MN 55414, United States.
| | - Alicia M Allen
- Department of Family & Community Medicine, University of Arizona, 3950 South Country Club Drive, Tucson, AZ 85714, United States.
| | - Sharon Allene
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 261, Minneapolis, MN 55414, United States.
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Gendy MNS, Ibrahim C, Sloan ME, Le Foll B. Randomized Clinical Trials Investigating Innovative Interventions for Smoking Cessation in the Last Decade. Handb Exp Pharmacol 2020; 258:395-420. [PMID: 31267165 DOI: 10.1007/164_2019_253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Every year, billions of dollars are spent treating smoking and related conditions, yet smoking-related morbidity and mortality continue to rise. There are currently only three FDA-approved medications for smoking cessation: nicotine replacement therapy, bupropion, and varenicline. Although these medications increase abstinence rates, most individuals relapse following treatment. This chapter reviews clinical trials published within the past 10 years investigating novel smoking cessation pharmacotherapies. Among these pharmacotherapies, some showed promising results, such as cytisine and endocannabinoid modulators, whereas others failed to produce significant effects. More research is needed to develop drugs that produce higher rates of long-term abstinence and to determine which subgroups of patients benefit from a given treatment.
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Affiliation(s)
- Marie N S Gendy
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Matthew E Sloan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
- Addictions Division, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
- Alcohol Research and Treatment Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
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Allen AM, Friedrichsen SC, Petersen N, Allen SS. Subjective response to intranasal nicotine administration in oral contraceptive users and naturally-cycling women. Addict Behav 2019; 98:106043. [PMID: 31310925 DOI: 10.1016/j.addbeh.2019.106043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 05/20/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Approximately half of premenopausal women who smoke cigarettes also use hormonal contraceptives, with most using oral contraceptives (OCs). While research on the effects of endogenous hormones on smoking-related outcomes continues to expand, little is known about the influence of OCs on similar outcomes. We sought to explore differences in the subjective response to nicotine by OC use after stratifying by testing condition (e.g., smoking status). METHODS Participants were regular (≥5 cigarettes/day) smokers, classified into OC and naturally cycling (NC) groups. All participants completed four total lab sessions by smoking status (ad libitum smoking, acute smoking abstinence) and anticipated progesterone level (low progesterone week (LPW), high progesterone week (HPW)). Each lab session included self-administration of intranasal nicotine (Time 0 min), assessment of subjective response via the Subjective State Scale (-30 and + 5 min). RESULTS Compared to the NC group (n = 28), the OC group (n = 14) was younger (26.2 ± 1.1 versus 24.2 ± 1.1; p < 0.001) and had a lower Fagerström Test for Nicotine Dependence score (3.4 ± 0.5 versus 2.6 ± 0.5; p = 0.011). Progesterone-to-estradiol ratios varied significantly by group at three of the four time points (p < 0.05). During ad libitum smoking, the OC group had significantly lower craving after nicotine administration than the NC group (1.93 ± 0.33 versus 2.89 ± 0.23; p = 0.024). No other significant differences in subjective response were identified. CONCLUSIONS Despite significantly different hormone levels, group differences in subjective response to nicotine were relatively few. Additional research is needed to elucidate the mechanisms involved in these observations, as well as explore how they may influence cessation in women.
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Affiliation(s)
- Alicia M Allen
- Department of Family & Community Medicine, College of Medicine, University of Arizona, 3950 South Country Club Drive, Suite 330, Tucson, AZ 85714-2238, USA.
| | | | - Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024, USA.
| | - Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 420 Delaware Street SE, Room A682, Minneapolis, MN 55455, USA.
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Tosun NL, Fieberg AM, Eberly LE, Harrison KA, Tipp AR, Allen AM, Allen SS. Exogenous progesterone for smoking cessation in men and women: a pilot double-blind, placebo-controlled randomized clinical trial. Addiction 2019; 114:1800-1813. [PMID: 31059177 PMCID: PMC6732045 DOI: 10.1111/add.14645] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/31/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS In some clinical studies men and women have been found to differ in their ability to quit smoking, perhaps as a result of progesterone. The primary aim of this study was to provide a preliminary test of whether progesterone (PRO), compared with placebo (PBO), was more effective for smoking cessation in men and women. DESIGN Pilot double-blind, placebo-controlled randomized clinical trial. SETTING Minneapolis/St Paul metro area, Minnesota, USA. PARTICIPANTS A total of 216 participants were randomized, including 113 men (18-60 years; PRO = 56, PBO = 57) and 103 women (18-50 years, pre-menopausal with self-reported regular menstrual cycles; PRO = 51, PBO = 52). INTERVENTION Participants were randomized (1 : 1 within sex group) to either PRO (200 mg twice daily) or PBO. Participants were assigned a quit date approximately 7 days after starting medication (luteal phase for women) and were followed for 12 weeks to assess relapse. MEASUREMENTS The primary outcome was self-reported 7-day point prevalence abstinence (PPA) at week 4. Secondary outcomes included 7-day PPA at weeks 8 and 12, prolonged abstinence, continuous abstinence, urine cotinine < 50 ng/ml, expired carbon monoxide ≤ 5 parts per million (p.p.m.) and days to relapse. FINDINGS There was a significant difference in 7-day PPA at week 4 among women [PRO: 18 (35.3%) versus PBO: 9 (17.3%), odds ratio (OR) = 2.61, 95% confidence interval (CI) = 1.04, 6.54, P = 0.041], but not among men [PRO: 13 (23.2%) versus PBO: 12 (21.1%), 1.13 (0.47, 2.76), P = 0.782]. There was some evidence that PRO delayed relapse in women (days to relapse; PRO: 20.5 ± 29.6 versus PBO: 14.3 ± 26.8, P = 0.03) but not in men (PRO: 13.4 ± 25.9 versus PBO: 13.3 ± 23.8, P = 0.69). CONCLUSIONS Oral micronized progesterone may aid smoking cessation in women.
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Affiliation(s)
- Nicole L Tosun
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Ann M Fieberg
- Coordinating Center for Biometric Research, University of Minnesota, Minneapolis, MN, USA
| | - Lynn E Eberly
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
| | - Katherine A Harrison
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Angela R Tipp
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Alicia M Allen
- Department of Family & Community Medicine, University of Arizona, Tucson, AZ, USA
| | - Sharon S Allen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Allen S, Harrison K, Petersen A, Goodson J. Smoking-related symptomatology in pregnant smokers during ad libitum smoking and following overnight smoking abstinence. BMC Res Notes 2019; 12:473. [PMID: 31370907 PMCID: PMC6669967 DOI: 10.1186/s13104-019-4503-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/20/2019] [Indexed: 12/02/2022] Open
Abstract
Objective Current literature suggests there may be a relationship between sex hormones, which dramatically increase during pregnancy, and nicotine use behaviors. We hypothesized that higher progesterone and progesterone:estradiol ratio (P/E2) would be associated with less smoking-related symptomatology (SRS), better mood and fewer cigarettes smoked per day (CPD) during ad libitum smoking and following overnight abstinence in pregnant women. Associations between SRS, mood, smoking behavior and sex hormones were estimated using multiple linear regression with adjustment for CPD and pregnancy trimester. Results There were 35 second trimester and 42 third trimester participants. Participants mean age was 26.2 (SD: 4.1), they smoked 11.3 CPD (SD: 4.4) and the mean nicotine dependence score was 4.94 (SD: 1.98). There were no statistically significant associations between progesterone levels, estradiol levels, or the P/E2 ratio and SRS or mood measures during ad libitum smoking or following overnight abstinence in this sample of pregnant women. Similarly, there were no associations between sex hormone levels and number of CPD smoked during the ad libitum period. Contrary to our hypothesis, we found no significant associations between sex hormones and SRS, mood or smoking behavior in this sample of pregnant women. Trial registration ClinicalTrials.gov (NCT01811225), December 6, 2012
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Affiliation(s)
- Sharon Allen
- Tobacco Research Programs, Department of Family Medicine & Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN, 55414, USA
| | - Katherine Harrison
- Tobacco Research Programs, Department of Family Medicine & Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN, 55414, USA.
| | - Ashley Petersen
- Division of Biostatistics, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Jane Goodson
- Tobacco Research Programs, Department of Family Medicine & Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN, 55414, USA
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McCarthy JM, Dumais KM, Zegel M, Pizzagalli DA, Olson DP, Moran LV, Janes AC. Sex differences in tobacco smokers: Executive control network and frontostriatal connectivity. Drug Alcohol Depend 2019; 195:59-65. [PMID: 30592997 PMCID: PMC6625360 DOI: 10.1016/j.drugalcdep.2018.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/19/2018] [Accepted: 11/19/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Women experience greater difficulty quitting smoking than men, which may be explained by sex differences in brain circuitry underlying cognitive control. Prior work has linked reduced interhemispheric executive control network (ECN) coupling with poor executive function, shorter time to relapse, and greater substance use. Lower structural connectivity between a key ECN hub, the dorsolateral prefrontal cortex (DLPFC), and the dorsal striatum (DS) also contributes to less efficient cognitive control recruitment, and reduced intrahemispheric connectivity between these regions has been associated with smoking relapse. Therefore, sex differences were probed by evaluating interhemispheric ECN and intrahemispheric DLPFC-DS connectivity. To assess the potential sex by nicotine interaction, a pilot sample of non-smokers was evaluated following acute nicotine and placebo administration. METHODS Thirty-five smokers (19 women) completed one resting state functional magnetic resonance imaging scan. Seventeen non-smokers (8 women) were scanned twice using a repeated measures design where they received 2 and 0 mg nicotine. RESULTS In smokers, women had less interhemispheric ECN and DLPFC-DS coupling than men. In non-smokers, there was a drug x sex interaction where women, relative to men, had weaker ECN coupling following nicotine but not placebo administration. CONCLUSIONS The current work indicates that nicotine-dependent women, versus men, have weaker connectivity in brain networks critically implicated in cognitive control. How these connectivity differences contribute to the behavioral aspects of smoking requires more testing. However, building on the literature, it is likely these deficits in functional connectivity contribute to the lower abstinence rates noted in women relative to men.
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Affiliation(s)
- Julie M McCarthy
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA.
| | - Kelly M Dumais
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Maya Zegel
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA
| | - Diego A Pizzagalli
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - David P Olson
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Lauren V Moran
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Amy C Janes
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
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Sherman BJ, Caruso MA, McRae-Clark AL. Exogenous progesterone for cannabis withdrawal in women: Feasibility trial of a novel multimodal methodology. Pharmacol Biochem Behav 2019; 179:22-26. [PMID: 30711528 DOI: 10.1016/j.pbb.2019.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/05/2018] [Accepted: 01/28/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sex differences in cannabis use disorder (CUD) and its treatment have been identified. Women report more severe withdrawal and have shown worse treatment outcomes. Ovarian hormones are implicated in these differences and research suggests that exogenous progesterone may be an effective pharmacotherapy. METHODS The current randomized, placebo-controlled, feasibility trial tested a novel multimodal methodology for administering exogenous progesterone during acute cannabis withdrawal. Eight heavy cannabis using women received micronized progesterone (200 mg bid) (n = 3) or matching placebo (n = 5) during the early follicular phase of their menstrual cycle over a 5-day study period while abstaining from cannabis. Laboratory visits (days 1 and 5) included biological and self-report assessments, while home-based procedures (days 2-4) included ambulatory assessments, video data capture and tele-drug testing, and biological assessments. Primary outcomes were medication adherence and salivary hormone levels, and the exploratory outcome was cannabis withdrawal severity. RESULTS Medication adherence rates were high as assessed via self-report (100.0%) and video data capture (98.0%). Salivary progesterone levels differed between groups over time (p < 0.027) and the progesterone group achieved levels within the normal range during the luteal phase in healthy adults. All tele-drug tests were negative confirming cannabis abstinence and there was an indication (p = 0.07) of reduced cannabis craving among participants receiving progesterone. CONCLUSION More effective and sex-based treatments for cannabis use disorder are needed. The current study provides a novel multimodal methodology with low participant burden for investigating new medications for cannabis withdrawal. Clinical trials of progesterone for cannabis withdrawal may be warranted.
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Affiliation(s)
- Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical Unviersity of South Carolina, 67 President Street, Charleston, SC 29425, USA.
| | - Margaret A Caruso
- Department of Psychology, Auburn University, 226 Thach Hall, AL 36849, USA
| | - Aimee L McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical Unviersity of South Carolina, 67 President Street, Charleston, SC 29425, USA; Ralph H. Johnson VAMC, 109 Bee Street, Charleston, SC 29401, USA
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Valentine GW, DeVito EE, Jatlow PI, Gueorguieva R, Sofuoglu M. Acute effects of inhaled menthol on the rewarding effects of intravenous nicotine in smokers. J Psychopharmacol 2018; 32:986-994. [PMID: 29788802 PMCID: PMC6329876 DOI: 10.1177/0269881118773972] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE This double-blind, placebo controlled study examined whether menthol inhaled from an electronic cigarette (e-cigarette) would change subjective and withdrawal alleviating effects of intravenous nicotine in young adult smokers. METHODS A total of 32 menthol-preferring smokers and 25 non-menthol-preferring smokers participated in the study that consisted of a random sequence of three different inhaled menthol conditions (0.0%, 0.5%, and 3.2%) across three test sessions (a single menthol condition per session). In each test session (performed at least 24 hours apart), a random order of saline, and two different nicotine infusions of 0.25 mg and 0.5 mg/70 kg of bodyweight were administered, one hour apart, concurrent with menthol inhalation. RESULTS While menthol did not alter the positive subjective effects of nicotine, menthol significantly enhanced aversive effects of nicotine in non-menthol-preferring smokers and reduced smoking urges in menthol-preferring smokers. In addition, menthol-preferring smokers reported blunted positive subjective responses to nicotine and less severe nicotine withdrawal after overnight nicotine deprivation. Finally, compared to non-menthol-preferring smokers, menthol-preferring smokers had a significantly lower baseline nicotine metabolite ratio indicating slower nicotine metabolism within our sample of menthol-preferring smokers. CONCLUSIONS Our findings did not support an enhancement of nicotine's positive subjective effects from inhaled menthol. However, as compared to non-menthol-preferring smokers, menthol-preferring smokers had blunted positive subjective responses to nicotine and reduced overnight withdrawal severity that may be partly due to inhibition of nicotine metabolism from chronic exposure to inhaled menthol. Collectively, these results reveal a more complex and nuanced role of inhaled menthol in smokers than previously recognized.
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Affiliation(s)
- Gerald W Valentine
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
| | - Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
| | - Peter I Jatlow
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
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Role of Exogenous Progesterone in the Treatment of Men and Women with Substance Use Disorders: A Narrative Review. CNS Drugs 2018; 32:421-435. [PMID: 29761343 PMCID: PMC6235727 DOI: 10.1007/s40263-018-0525-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Substance use disorders (SUDs) remain problematic as many individuals are untreated or do not benefit from the currently available interventions. Thus, there is an urgent need to develop novel pharmacological interventions to treat SUDs. Evidence suggests that the female sex hormone, progesterone, attenuates the craving for and the euphoric effects of drugs of abuse. Research to date has demonstrated that progesterone may modulate responses to drugs of abuse and may have utility as a novel treatment for SUDs. A literature search was conducted to identify and examine studies that administered exogenous progesterone. Sixteen publications were identified, exploring the utility of exogenous progesterone or its metabolite, allopregnanolone, among a range of substances, including amphetamines (one study), benzodiazepines (one study), cocaine (nine studies), and tobacco/nicotine (five studies). Results indicated that exogenous progesterone and, its metabolite allopregnanolone, demonstrated preliminary efficacy as a treatment for substance use in both men and women. Notably, progesterone appears to target negative affect and augment cognitive functioning, especially among female substance users. Additional research is needed to explore the potential use of exogenous progesterone and allopregnanolone in the treatment of SUDs, including that associated with alcohol and opioids, but considering the current promising findings, exogenous progesterone and allopregnanolone may have utility as novel pharmacological treatments for SUDs.
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Ovarian Hormones and Transdermal Nicotine Administration Independently and Synergistically Suppress Tobacco Withdrawal Symptoms and Smoking Reinstatement in the Human Laboratory. Neuropsychopharmacology 2018; 43:828-837. [PMID: 28905874 PMCID: PMC5809791 DOI: 10.1038/npp.2017.216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/08/2017] [Accepted: 09/10/2017] [Indexed: 12/19/2022]
Abstract
Modeling intra-individual fluctuations in estradiol and progesterone may provide unique insight into the effects of ovarian hormones on the etiology and treatment of nicotine dependence. This randomized placebo-controlled laboratory study tested the independent and interactive effects of intra-individual ovarian hormone variation and nicotine on suppression of tobacco withdrawal symptoms and smoking behavior. Female smokers randomized to 21 mg nicotine (TNP; n=37) or placebo (PBO; n=43) transdermal patch following overnight abstinence completed three sessions occurring during hormonally distinct menstrual cycle phases. At each session, participants provided saliva for hormone assays and completed repeated self-report measures (ie, tobacco withdrawal symptoms, smoking urge, and negative affect (NA)) followed by an analog smoking reinstatement task for which participants could earn money to delay smoking and subsequently purchase cigarettes to smoke. Higher (vs lower) progesterone levels were associated with greater reductions in NA. Higher (vs lower) progesterone levels and progesterone to estradiol ratios were associated with reducing smoking urges over time to a greater extent with TNP compared to PBO. There was an interaction between Patch and estradiol on NA. With TNP, higher-than-usual estradiol was associated with greater decreases in NA. However with PBO, lower-than-usual estradiol was associated with greater decreases in NA. These results suggest that the effects of TNP on mood- and smoking-related outcomes may vary depending on the ovarian hormone levels.
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Forray A, Gilstad-Hayden K, Suppies C, Bogen D, Sofuoglu M, Yonkers KA. Progesterone for smoking relapse prevention following delivery: A pilot, randomized, double-blind study. Psychoneuroendocrinology 2017; 86:96-103. [PMID: 28926762 PMCID: PMC5659923 DOI: 10.1016/j.psyneuen.2017.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 08/24/2017] [Accepted: 09/06/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Close to half of women who were smokers prior to conception quit smoking in pregnancy, when endogenous progesterone levels are high. However, at least half resume pre-pregnancy smoking levels within weeks after delivery and when progesterone levels drop. The current pilot study tested the feasibility and preliminary efficacy of postpartum progesterone replacement in preventing relapse to smoking in postpartum women with a history of pre-pregnancy smoking. METHODS This was an 8-week, double-blind, parallel, randomized, placebo-controlled pilot trial of 41 women with a history of pre-pregnancy smoking who achieved abstinence by 32 weeks of gestation. Immediately following delivery women were randomized to oral micronized progesterone (200mg twice daily) or placebo via computerized urn randomization program. The main outcome measures were descriptions of study feasibility: recruitment and retention. Secondary outcomes were 7-day point prevalence of abstinence at week 8, time to relapse and smoking cravings. RESULTS The trial was feasible with adequate randomization, 64% (41/64) of eligible women, and trial retention, 78% (32/41) completed the trial. Women taking progesterone were 1.8 times more likely to be abstinent during week 8 and took longer to relapse (10 vs. 4 weeks) compared to the placebo group, although these differences did not reach statistical significance. After adjusting for age and pre-quit smoking level, the number needed to treat was 7. There was a 10% greater decline per week in craving ratings in the progesterone group compared to placebo (β=-0.10, 95% CI: -0.15, -0.04, p<0.01). No serious adverse events occurred during the trial. CONCLUSIONS These preliminary findings support the promise of progesterone treatment in postpartum smokers and could constitute a therapeutic breakthrough.If these preliminary findings can be evaluated and replicated in a larger study with sufficient power, this may constitute an acceptable and safe smoking relapse prevention strategy for use during lactation.
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Affiliation(s)
- Ariadna Forray
- Department of Psychiatry, Yale School of Medicine,40 Temple Street, Suite 6B, New Haven, CT, 06510, United States.
| | - Kathryn Gilstad-Hayden
- Department of Psychiatry, Yale School of Medicine,40 Temple Street, Suite 6B, New Haven, CT, 06510, United States
| | - Cristine Suppies
- Department of Psychiatry, Yale School of Medicine,40 Temple Street, Suite 6B, New Haven, CT, 06510, United States
| | - Debra Bogen
- Department of Pediatrics, University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA, 15213, United States
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine,40 Temple Street, Suite 6B, New Haven, CT, 06510, United States; VA Connecticut Healthcare System, Building 35, 950 Campbell Avenue, West Haven, CT, 06516, United States
| | - Kimberly A Yonkers
- Department of Psychiatry, Yale School of Medicine,40 Temple Street, Suite 6B, New Haven, CT, 06510, United States; Department of Obstetrics, Gynecology, & Reproductive Sciences, Yale School of Medicine,20 York Street, New Haven, CT, 06510, United States
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Pogun S, Yararbas G, Nesil T, Kanit L. Sex differences in nicotine preference. J Neurosci Res 2017; 95:148-162. [PMID: 27870459 DOI: 10.1002/jnr.23858] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/29/2016] [Accepted: 07/11/2016] [Indexed: 01/01/2023]
Abstract
Smoking is the major cause of preventable deaths worldwide, and although there is a decline in overall smoking prevalence in developed countries, the decline in women is less pronounced than in men. Women become dependent faster and experience greater difficulties in quitting. Similar trends have been observed in animal models of nicotine/tobacco addiction. Individual differences in vulnerability to drug abuse are also observed in nicotine/tobacco addiction and point to the importance of sex differences. This Review, summarizes findings from three experimental approaches used to depict nicotine preference in animal models, intravenous and oral nicotine self-administration and nicotine-induced conditioned place preference. Nicotine preference is considered to be reflected in the animal's motivation to administer the drug (intravenously or orally) or to prefer an environment paired with the presence of the drug (conditioned place preference). These approaches all point to the importance of sex and age of the subjects; the preference of females and adolescents appear to be more pronounced than that of males and adults, respectively. A closer look at these factors will help us understand the mechanisms that underlie nicotine addiction and develop strategies to cope. Ignoring sex differences and reaching conclusions based only on studies using male subjects has resulted in erroneous generalizations in the past. Sex differences in nicotine preference have been clearly documented, and awareness on this aspect of nicotine dependence will significantly impact our success in translational research. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sakire Pogun
- Center for Brain Research, Ege University, Izmir, Turkey
| | - Gorkem Yararbas
- Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Izmir, Turkey
| | - Tanseli Nesil
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia
| | - Lutfiye Kanit
- Center for Brain Research, Ege University, Izmir, Turkey.,Physiology Department, School of Medicine, Ege University, Izmir, Turkey
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Rasmusson AM, Marx CE, Pineles SL, Locci A, Scioli-Salter ER, Nillni YI, Liang JJ, Pinna G. Neuroactive steroids and PTSD treatment. Neurosci Lett 2017; 649:156-163. [PMID: 28215878 DOI: 10.1016/j.neulet.2017.01.054] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 01/08/2023]
Abstract
This review highlights early efforts to translate pre-clinical and clinical findings regarding the role of neuroactive steroids in stress adaptation and PTSD into new therapeutics for PTSD. Numerous studies have demonstrated PTSD-related alterations in resting levels or the reactivity of neuroactive steroids and their targets. These studies also have demonstrated substantial variability in the dysfunction of specific neuroactive steroid systems among PTSD subpopulations. These variabilities have been related to the developmental timing of trauma, severity and type of trauma, genetic background, sex, reproductive state, lifestyle influences such as substance use and exercise, and the presence of comorbid conditions such as depression and chronic pain. Nevertheless, large naturalistic studies and a small placebo-controlled interventional study have revealed generally positive effects of glucocorticoid administration in preventing PTSD after trauma, possibly mediated by glucocorticoid receptor-mediated effects on other targets that impact PTSD risk, including other neuroactive steroid systems. In addition, clinical and preclinical studies show that administration of glucocorticoids, 17β-estradiol, and GABAergic neuroactive steroids or agents that enhance their synthesis can facilitate extinction and extinction retention, depending on dose and timing of dose in relation to these complex PTSD-relevant recovery processes. This suggests that clinical trials designed to test neuroactive steroid therapeutics in PTSD may benefit from such considerations; typical continuous dosing regimens may not be optimal. In addition, validated and clinically accessible methods for identifying specific neuroactive steroid system abnormalities at the individual level are needed to optimize both clinical trial design and precision medicine based treatment targeting.
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Affiliation(s)
- Ann M Rasmusson
- National Center for PTSD, Women's Health Science Division, Department of Veterans Affairs 150 South Huntington Avenue, Boston, MA 02135, USA; VA Boston Healthcare System 150 South Huntington Avenue, Boston, MA 02135, USA; Boston University School of Medicine 72 E Concord St, Boston, MA 02118, USA.
| | - Christine E Marx
- Durham VA Medical Center, VA Mid-Atlantic MIRECC,and Duke University Medical Center, 508 Fulton Street, Durham, NC 27705, USA
| | - Suzanne L Pineles
- National Center for PTSD, Women's Health Science Division, Department of Veterans Affairs 150 South Huntington Avenue, Boston, MA 02135, USA; Boston University School of Medicine 72 E Concord St, Boston, MA 02118, USA
| | - Andrea Locci
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Str., Chicago, IL 60612, USA
| | - Erica R Scioli-Salter
- VA Boston Healthcare System 150 South Huntington Avenue, Boston, MA 02135, USA; Boston University School of Medicine 72 E Concord St, Boston, MA 02118, USA
| | - Yael I Nillni
- National Center for PTSD, Women's Health Science Division, Department of Veterans Affairs 150 South Huntington Avenue, Boston, MA 02135, USA; Boston University School of Medicine 72 E Concord St, Boston, MA 02118, USA
| | - Jennifer J Liang
- Boston University School of Medicine 72 E Concord St, Boston, MA 02118, USA
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Str., Chicago, IL 60612, USA
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Neurosteroids Involvement in the Epigenetic Control of Memory Formation and Storage. Neural Plast 2016; 2016:5985021. [PMID: 28090360 PMCID: PMC5206442 DOI: 10.1155/2016/5985021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/10/2016] [Indexed: 12/14/2022] Open
Abstract
Memory is our ability to store and remember past experiences; it is the result of changes in neuronal circuits of specific brain areas as the hippocampus. During memory formation, neurons integrate their functions and increase the strength of their connections, so that synaptic plasticity is improved and consolidated. All these processes recruit several proteins at the synapses, whose expression is highly regulated by DNA methylation and histone tails posttranslational modifications. Steroids are known to influence memory process, and, among them, neurosteroids are implicated in neurodegenerative disease related to memory loss and cognitive impairment. The epigenetic control of neurosteroids involvement in memory formation and maintenance could represent the basis for neuroregenerative therapies.
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Allen SS, Allen AM, Lunos S, Tosun N. Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial. Nicotine Tob Res 2016; 18:2145-2153. [PMID: 27613934 PMCID: PMC5055745 DOI: 10.1093/ntr/ntw156] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/05/2016] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Pregnancy is a strong motivator to quit smoking, yet postpartum relapse rates are high. Growing evidence suggests a role of sex hormones in drug abuse behavior and given the precipitous drop in sex hormones at delivery, they may play a role in postpartum relapse. This pilot study evaluates the feasibility and potential role of exogenous progesterone in postpartum smoking relapse. METHODS This 12-week double-blind placebo-controlled randomized pilot trial randomized 46 abstinent postpartum women to active progesterone (PRO; 200mg twice a day) versus placebo (PBO) for 4 weeks. Participants were followed for relapse for 12 weeks. Main study outcomes include abstinence (point prevalence), feasibility (compliance per number of clinic visits attended, pill counts and Electronic Data Capture [EDC] completed) and self-reported acceptability. Safety was also measured by depressive symptom scores, adverse events, and breastfeeding. RESULTS Overall retention rate was 87% at week 12. At week 4, abstinence rates were 75% in the PRO group and 68.2% in the PBO group (p = .75). Medication adherence was 68% and clinic visit attendance was 80%, with no differences by randomization. Depressive symptom scores, adverse events, and breastfeeding did not vary by randomization. CONCLUSIONS Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence at week 4 in the PRO group. Further, exogenous progesterone was well tolerated and did not adversely affect depressive symptoms or breastfeeding. Thus, the results of this pilot study indicate further investigation into progesterone as a postpartum relapse prevention strategy is warranted. IMPLICATIONS This innovative pilot trial determined the feasibility of delivering exogenous progesterone as a potential prevention of postpartum smoking relapse. We observed high retention and moderate adherence rates, as well as high acceptability among participants. Further, though not statistically significant, more women in the treatment group remained abstinent from smoking during follow-up. This project adds to the growing body of literature on the role of sex hormones in smoking relapse and also provides support for a fully powered clinical trial.
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Affiliation(s)
- Sharon S Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN;
| | - Alicia M Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Nicole Tosun
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN
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Carroll ME, Lynch WJ. How to study sex differences in addiction using animal models. Addict Biol 2016; 21:1007-29. [PMID: 27345022 PMCID: PMC4970981 DOI: 10.1111/adb.12400] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 02/17/2016] [Accepted: 02/27/2016] [Indexed: 11/30/2022]
Abstract
The importance of studying sex as a biological variable in biomedical research is becoming increasingly apparent. There is a particular need in preclinical studies of addiction to include both sexes, as female animals are often excluded from studies, leaving large gaps in our knowledge of not only sex differences and potential prevention and treatment strategies but also with regard to the basic neurobiology of addiction. This review focuses on methodology that has been developed in preclinical studies to examine sex differences in the behavioral aspects and neurobiological mechanisms related to addiction across the full range of the addiction process, including initiation (acquisition), maintenance, escalation, withdrawal, relapse to drug seeking and treatment. This review also discusses strategic and technical issues that need to be considered when comparing females and males, including the role of ovarian hormones and how sex differences interact with other major vulnerability factors in addiction, such as impulsivity, compulsivity and age (adolescent versus adult). Novel treatments for addiction are also discussed, such as competing non-drug rewards, repurposed medications such as progesterone and treatment combinations. Practical aspects of conducting research comparing female and male animals are also considered. Making sex differences a point of examination requires additional effort and consideration; however, such studies are necessary given mounting evidence demonstrating that the addiction process occurs differently in males and females. These studies should lead to a better understanding of individual differences in the development of addiction and effective treatments for males and females.
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Affiliation(s)
- Marilyn E. Carroll
- Marilyn E. Carroll, Department of Psychiatry, University of Minnesota, MMC 392, Minneapolis, MN, USA
| | - Wendy J. Lynch
- Wendy J. Lynch, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 801402, Charlottesville, VA
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Brents LK. Marijuana, the Endocannabinoid System and the Female Reproductive System. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2016; 89:175-91. [PMID: 27354844 PMCID: PMC4918871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Marijuana use among women is highly prevalent, but the societal conversation on marijuana rarely focuses on how marijuana affects female reproduction and endocrinology. This article reviews the current scientific literature regarding marijuana use and hypothalamic-pituitary-ovarian (HPO) axis regulation, ovarian hormone production, the menstrual cycle, and fertility. Evidence suggests that marijuana can reduce female fertility by disrupting hypothalamic release of gonadotropin releasing hormone (GnRH), leading to reduced estrogen and progesterone production and anovulatory menstrual cycles. Tolerance to these effects has been shown in rhesus monkeys, but the effects of chronic marijuana use on human female reproduction are largely unknown. Marijuana-induced analgesia, drug reinforcement properties, tolerance, and dependence are influenced by ovarian hormones, with estrogen generally increasing and progesterone decreasing sensitivity to marijuana. Carefully controlled regulation of the Endocannabinoid System (ECS) is required for successful reproduction, and the exogenous cannabinoids in marijuana may disrupt the delicate balance of the ECS in the female reproductive system.
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Wetherill RR, Franklin TR, Allen SS. Ovarian hormones, menstrual cycle phase, and smoking: a review with recommendations for future studies. CURRENT ADDICTION REPORTS 2016; 3:1-8. [PMID: 27134810 DOI: 10.1007/s40429-016-0093-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cigarette smoking continues to be the leading cause of preventable morbidity and mortality. Similar to other addictive substances, the prevalence of cigarette smoking is greater among men than women, yet women are less successful at quitting smoking. Preclinical and clinical research suggests that ovarian hormones (i.e., estradiol and progesterone), which fluctuate over the course of the menstrual cycle, may contribute to these sex differences. Specifically, research suggests that progesterone may protect against cigarette smoking and nicotine addiction; whereas estradiol may underlie enhanced vulnerability. In this review, we discuss new research on ovarian hormone and menstrual cycle phase effects on smoking-related responses and behavior in women, including studies examining neural responses to smoking cues, hormonal influences on medication-assisted smoking cessation, and acute smoking abstinence. We highlight innovative studies with strong research methodology and provide suggestions for future research that may allow evidence-based knowledge for immediate translation to the clinic to guide novel, hormonally-informed treatment strategies. Thus, rigorous scientific study holds the potential to reduce relapse rates, thus improving the health and saving the lives of the many thousands of women who unfortunately do not respond to current treatments.
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Affiliation(s)
- Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Mailing Address: 3900 Chestnut Street, Philadelphia, Pennsylvania, USA 19104;
| | - Teresa R Franklin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Mailing Address: 3900 Chestnut Street, Philadelphia, Pennsylvania, USA 19104;
| | - Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota; Mailing Address: 420 Delaware Street SE, MMC 381 Mayo, Minneapolis, Minnesota, USA 55455;
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Saladin ME, McClure EA, Baker NL, Carpenter MJ, Ramakrishnan V, Hartwell KJ, Gray KM. Increasing progesterone levels are associated with smoking abstinence among free-cycling women smokers who receive brief pharmacotherapy. Nicotine Tob Res 2015; 17:398-406. [PMID: 25762749 DOI: 10.1093/ntr/ntu262] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Preclinical and human laboratory research suggests that (a) progesterone may decrease drug reward, craving, and smoking behavior, and (b) estradiol may enhance drug reward and smoking behavior. A modest majority of treatment research examining the relationship between menstrual cycle phase and outcomes suggests that the luteal menstrual phase, with its uniquely higher progesterone levels, is associated with better cessation outcomes. However, no studies to date have examined the effects of naturally occurring variation in progesterone and estradiol levels on medication-assisted smoking cessation. The present study sought to fill this notable gap in the treatment literature. METHODS Weekly plasma progesterone and estradiol levels were obtained from nicotine-dependent female smokers enrolled in a 4-week cessation trial. Participants (N = 108) were randomized to receive a 4-week course of either varenicline (VAR) tablets and placebo patches or placebo tablets and nicotine patches. Plasma samples were obtained 1 week before their cessation attempt and weekly during medication administration. Abstinence was assessed weekly. RESULTS Weekly hormone data replicated commonly observed menstrual cycle patterns of progesterone and estradiol levels. Importantly, increases in progesterone level were associated with a 23% increase in the odds for being abstinent within each week of treatment. This effect was driven primarily by nicotine patch-treated versus VAR-treated females. CONCLUSIONS This study was the first to identify an association between progesterone level (increasing) and abstinence outcomes in free-cycling women smokers who participated in a medication-based treatment. Furthermore, the potential benefits of progesterone may vary across different pharmacotherapies. Implications of these findings for smoking cessation intervention are discussed.
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Affiliation(s)
- Michael E Saladin
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC; Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC;
| | - Erin A McClure
- Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC
| | - Nathaniel L Baker
- Department Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Matthew J Carpenter
- Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | | | - Karen J Hartwell
- Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC; Substance Abuse Treatment Center, Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Kevin M Gray
- Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC; Youth Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
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Weinberger AH, Smith PH, Allen SS, Cosgrove KP, Saladin ME, Gray KM, Mazure CM, Wetherington CL, McKee SA. Systematic and meta-analytic review of research examining the impact of menstrual cycle phase and ovarian hormones on smoking and cessation. Nicotine Tob Res 2015; 17:407-21. [PMID: 25762750 DOI: 10.1093/ntr/ntu249] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION To determine the effect of ovarian hormones on smoking, we conducted a systematic review of menstrual cycle effects on smoking (i.e., ad lib smoking, smoking topography, and subjective effects) and cessation-related behaviors (i.e., cessation, withdrawal, tonic craving, and cue-induced craving). METHODS Thirty-six papers were identified on MEDLINE that included a menstrual-related search term (e.g., menstrual cycle, ovarian hormones), a smoking-related search term (e.g., smoking, nicotine), and met all inclusion criteria. Thirty-two studies examined menstrual phase, 1 study measured hormone levels, and 3 studies administered progesterone. RESULTS Sufficient data were available to conduct meta-analyses for only 2 of the 7 variables: withdrawal and tonic craving. Women reported greater withdrawal during the luteal phase than during the follicular phase, and there was a nonsignificant trend for greater tonic craving in the luteal phase. Progesterone administration was associated with decreased positive and increased negative subjective effects of nicotine. Studies of menstrual phase effects on the other outcome variables were either small in number or yielded mixed outcomes. CONCLUSIONS The impact of menstrual cycle phase on smoking behavior and cessation is complicated, and insufficient research is available upon which to conduct meta-analyses on most smoking outcomes. Future progress will require collecting ovarian hormone levels to more precisely quantify the impact of dynamic changes in hormone levels through the cycle on smoking behavior. Clarifying the relationship between hormones and smoking-particularly related to quitting, relapse, and medication response-could determine the best type and timing of interventions to improve quit rates for women.
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Affiliation(s)
| | - Philip H Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Sharon S Allen
- Women's Health Research at Yale, Yale University School of Medicine, New Haven, CT
| | - Kelly P Cosgrove
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN
| | - Michael E Saladin
- Departments of Psychiatry, Diagnostic Radiology, and Neurobiology, Yale University School of Medicine, New Haven, CT
| | - Kevin M Gray
- Departments of Health Sciences and Research and Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Carolyn M Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Women's Health Research at Yale, Yale University School of Medicine, New Haven, CT
| | - Cora Lee Wetherington
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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Walf AA, Koonce CJ, Frye CA. Progestogens' effects and mechanisms for object recognition memory across the lifespan. Behav Brain Res 2015; 294:50-61. [PMID: 26235328 DOI: 10.1016/j.bbr.2015.07.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/16/2015] [Accepted: 07/28/2015] [Indexed: 12/11/2022]
Abstract
This review explores the effects of female reproductive hormones, estrogens and progestogens, with a focus on progesterone and allopregnanolone, on object memory. Progesterone and its metabolites, in particular allopregnanolone, exert various effects on both cognitive and non-mnemonic functions in females. The well-known object recognition task is a valuable experimental paradigm that can be used to determine the effects and mechanisms of progestogens for mnemonic effects across the lifespan, which will be discussed herein. In this task there is little test-decay when different objects are used as targets and baseline valance for objects is controlled. This allows repeated testing, within-subjects designs, and longitudinal assessments, which aid understanding of changes in hormonal milieu. Objects are not aversive or food-based, which are hormone-sensitive factors. This review focuses on published data from our laboratory, and others, using the object recognition task in rodents to assess the role and mechanisms of progestogens throughout the lifespan. Improvements in object recognition performance of rodents are often associated with higher hormone levels in the hippocampus and prefrontal cortex during natural cycles, with hormone replacement following ovariectomy in young animals, or with aging. The capacity for reversal of age- and reproductive senescence-related decline in cognitive performance, and changes in neural plasticity that may be dissociated from peripheral effects with such decline, are discussed. The focus here will be on the effects of brain-derived factors, such as the neurosteroid, allopregnanolone, and other hormones, for enhancing object recognition across the lifespan.
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Affiliation(s)
- Alicia A Walf
- Dept. of Psychology, The University at Albany-SUNY, Albany, NY 12222, USA; The Center for Life Sciences Research, The University at Albany-SUNY, Albany, NY 12222, USA; Institute of Arctic Biology, The University of Alaska-Fairbanks, Fairbanks, Alaska 99775, USA; The University of Alaska-Fairbanks, IDeA Network of Biomedical Excellence (INBRE), Fairbanks, Alaska 99775, USA; Cognitive Science Department, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Carolyn J Koonce
- Dept. of Psychology, The University at Albany-SUNY, Albany, NY 12222, USA; Institute of Arctic Biology, The University of Alaska-Fairbanks, Fairbanks, Alaska 99775, USA; The University of Alaska-Fairbanks, IDeA Network of Biomedical Excellence (INBRE), Fairbanks, Alaska 99775, USA
| | - Cheryl A Frye
- Dept. of Psychology, The University at Albany-SUNY, Albany, NY 12222, USA; Dept. of Biological Sciences, The University at Albany-SUNY, Albany, NY 12222, USA; The Center for Neuroscience, The University at Albany-SUNY, Albany, NY 12222, USA; The Center for Life Sciences Research, The University at Albany-SUNY, Albany, NY 12222, USA; Department of Chemistry and Biochemistry, The University of Alaska-Fairbanks, Fairbanks, Alaska 99775, USA; Institute of Arctic Biology, The University of Alaska-Fairbanks, Fairbanks, Alaska 99775, USA; The University of Alaska-Fairbanks, IDeA Network of Biomedical Excellence (INBRE), Fairbanks, Alaska 99775, USA.
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Colciago A, Casati L, Negri-Cesi P, Celotti F. Learning and memory: Steroids and epigenetics. J Steroid Biochem Mol Biol 2015; 150:64-85. [PMID: 25766520 DOI: 10.1016/j.jsbmb.2015.02.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 12/19/2022]
Abstract
Memory formation and utilization is a complex process involving several brain structures in conjunction as the hippocampus, the amygdala and the adjacent cortical areas, usually defined as medial temporal lobe structures (MTL). The memory processes depend on the formation and modulation of synaptic connectivity affecting synaptic strength, synaptic plasticity and synaptic consolidation. The basic neurocognitive mechanisms of learning and memory are shortly recalled in the initial section of this paper. The effect of sex hormones (estrogens, androgens and progesterone) and of adrenocortical steroids on several aspects of memory processes are then analyzed on the basis of animal and human studies. A specific attention has been devoted to the different types of steroid receptors (membrane or nuclear) involved and on local metabolic transformations when required. The review is concluded by a short excursus on the steroid activated epigenetic mechanisms involved in memory formation.
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Affiliation(s)
- Alessandra Colciago
- Department of Pharmacological and Biomolecular Sciences, Section of Biomedicine and Endocrinology, Via Balzaretti 9, 20133 Milano, Italy
| | - Lavinia Casati
- Department of Medical Biotechnologies and Translational Medicine, Via Vanvitelli 32, 20129 Milano, Italy
| | - Paola Negri-Cesi
- Department of Pharmacological and Biomolecular Sciences, Section of Biomedicine and Endocrinology, Via Balzaretti 9, 20133 Milano, Italy
| | - Fabio Celotti
- Department of Pharmacological and Biomolecular Sciences, Section of Biomedicine and Endocrinology, Via Balzaretti 9, 20133 Milano, Italy
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Abstract
There are significant gender differences in course, symptomology, and treatment of substance use disorders. In general data from clinical and preclinical studies of substance use disorders suggest that women are more vulnerable than men to the deleterious consequences of drug use at every phase of the addiction process. In addition data from epidemiologic studies suggest that the gender gap in the prevalence of substance use is narrowing particularly among adolescence. Therefore, understanding the role of estrogen and progesterone in mediating responses to drugs of abuse is of critical importance to women's health. In this review we will discuss findings from clinical and preclinical studies of (1) reproductive cycle phase; (2) endogenous ovarian hormones; and (3) hormone replacement on responses to stimulants, nicotine, alcohol, opioids, and marijuana. In addition, we discuss data from recent studies that have advanced our understanding of the neurobiologic mechanisms that interact with estrogen and progesterone to mediate drug-seeking behavior.
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Milivojevic V, Sinha R, Morgan PT, Sofuoglu M, Fox HC. Effects of endogenous and exogenous progesterone on emotional intelligence in cocaine-dependent men and women who also abuse alcohol. Hum Psychopharmacol 2014; 29:589-98. [PMID: 25363303 PMCID: PMC4498951 DOI: 10.1002/hup.2446] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/16/2014] [Accepted: 09/26/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE As sex differences in substance dependence may impinge upon the perception and regulation of emotion, we assess emotional intelligence (EI) as a function of gender, menstrual cycle (MC) phase and hormonal changes in early abstinent cocaine-dependent individuals who abuse alcohol (CDA). METHODS Study 1: The Mayer, Salovey, and Caruso Emotional Intelligence Test (MSCEIT) was administered to 98 CDA (55 M/43 F) and 56 healthy (28 M/28 F) individuals. Performance in women was also assessed by MC phase. Study 2: The MSCEIT was administered to 28 CDA (19 M/9 F) who received exogenous progesterone (400 mg/day) versus placebo for 7 days (study 2). RESULTS Study 1: Healthy females were better than healthy males at facilitating thought and managing emotions. This gender discrepancy was not observed in the CDA group. Additionally, all women in the high compared with the low progesterone phase of their MC were better at managing their emotions. Study 2: Exogenous progesterone improved ability to facilitate thought in both males and females. CONCLUSIONS CDA women may be vulnerable to difficulties managing and regulating emotions. Gonadal hormones may contribute to this gender effect, as increases in both endogenous and exogenous progesterone improved selective aspects of EI.
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Affiliation(s)
- V Milivojevic
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519
| | - R Sinha
- The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry 2 Church Street South, Suite 209, New Haven, CT 06519
| | - PT Morgan
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519
| | - M Sofuoglu
- VA Medical Center, 950 Campbell Ave, # 36, West Haven, CT 06516, USA
| | - HC Fox
- The Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519
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Yonkers KA, Forray A, Nich C, Carroll KM, Hine C, Merry BC, Shaw H, Shaw J, Sofuoglu M. Progesterone Reduces Cocaine Use in Postpartum Women with a Cocaine Use Disorder: A Randomized,Double-Blind Study. Lancet Psychiatry 2014; 1:360-367. [PMID: 25328863 PMCID: PMC4199242 DOI: 10.1016/s2215-0366(14)70333-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Progesterone modulates multiple brain functions implicated in the pathogenesis ofdrug addiction. During high endogenous progesterone states, women reduce use of cocaine. We sought to test whether progesterone replacement reduces cocaine use in postpartum women with a cocaine use disorder (CUD). METHODS A 12-week, double-blind, parallel, randomized, placebo-controlled pilot trial with a 3-month post trial follow-up. 25 women within 12 weeks of deliverywere randomized to placeboand 25 to100 mgs of oral micronized progesterone, administered twice daily. Participants were recruited from obstetrical clinics. Randomization and allocation were performed by the study biostatistician. Attrition was 18% and the analysis included all50participants. Outcomes were self-reported days of cocaine use and positive urine toxicology assays for cocaine metabolites. FINDINGS Participants randomized to placebo compared to progesterone had increased likelihood of cocaine use per week (RR=1·19; 95% confidence interval (CI)=1·05 to 1·36; p<0·01). At the three-month post trial visit the difference between groups was not significant (Likelihood RatioΧ2 =5·16; P=·08). There were no group differences in rates of submission of a positive urine test. A post hoc analysis showed a higher rate of relapse for participants randomized to placebo (HR=4·71; 95% CI= 1·09 to 20·5). We did not observe groups differences in the rate of adverse events. INTERPRETATION These preliminary findings support the promise of progesterone treatment in postpartum women with a CUD and could constitute a therapeutic break through. FUNDING US National Institute on Drug Abuse; Veterans Administration.
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Affiliation(s)
- Kimberly Ann Yonkers
- Departments of Psychiatry, Obstetrics and Gynecology and School of Epidemiology and Public Health, Yale University School of Medicine,40 Temple Street, Suite 6B, New Haven, Connecticut, USA 06510
| | - Ariadna Forray
- Department of Psychiatry, Yale University School of Medicine,40 Temple Street, Suite 6B, New Haven, Connecticut, USA 06510
| | - Charla Nich
- Department of Psychiatry, Yale University School of Medicine, VA CT Healthcare System, 950 Campbell Avenue, West Haven, CT 06516
| | - Kathleen M Carroll
- Department of Psychiatry, Yale University School of Medicine, VA CT Healthcare System, 950 Campbell Avenue, West Haven, CT 06516
| | - Cristine Hine
- Department of Psychiatry, Yale University School of Medicine,40 Temple Street, Suite 6B New Haven, Connecticut, USA 06510
| | - Brian C Merry
- Department of Psychiatry, Yale University School of Medicine,40 Temple Street, Suite 6B, New Haven, Connecticut, USA 06510
| | - Howard Shaw
- Department of Obstetrics and Gynecology, Yale New Haven Hospital, 1450 Chapel Street, New Haven, CT 06511
| | - Julia Shaw
- Department of Obstetrics and Gynecology, Yale University School of Medicine, 20 York St, New Haven, CT 06511
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale University School of Medicine, VA CT Healthcare System, 950 Campbell Avenue, West Haven, CT 06516
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Abstract
A variety of evidence suggests that, among humans, the individual tendency to choose immediate rewards ("Now") over larger, delayed rewards ("Later"), or Now bias, varies with frontal dopamine (DA) levels. As cyclic elevations in estradiol (E+) modulate other frontal DA-dependent behaviors, we tested ovarian cycle effects on Now bias, and whether any such effects are E+ mediated. To do so, we quantified Now/Later choice behavior in naturally cycling adult females (n = 87; ages 18-40 years) during both the menstrual phase (MP; cycle day 1-2; low E+), and the follicular phase (FP; cycle day 11-12; high E+). Now bias decreased an average of 3.6% from MP to FP (p = 0.006). Measures of salivary E+ levels at each visit were available in a subsample of participants (n = 34). Participants with a verified E+ rise from MP to FP showed significantly greater decreases in Now bias at mid-cycle (n = 23) than those without a rise (n = 11; p = 0.03); Now bias decreased an average of 10.2% in the E+ rise group but increased an average of 7.9% in the no E+ rise group. The change in Now bias from MP to FP inversely correlated with the change in E+ (ρ = -0.39; p = 0.023), an effect driven by individuals with putatively lower frontal DA based on genotype at the Val(158)Met polymorphism in the COMT gene. This is the first demonstration that intertemporal choice varies across the ovarian cycle, with Now bias declining at mid-cycle, when fertility peaks. Moreover, our data suggest that the interacting effects of estradiol and frontal DA mediate this cycle effect on decision making.
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