Effects of stimulants and atomoxetine on cortisol levels in children with ADHD
ABSTRACT Children with attention deficit hyperactivity disorder (ADHD) have lower diurnal cortisol levels than non-ADHD-comparisons. Aiming at elucidating effects of ADHD-medication we investigated saliva cortisol in children with ADHD: 20 without medication, 147 on methylphenidate, and 21 on atomoxetine. The only significant finding was that children on atomoxetine had higher cortisol levels at bedtime than non-medicated.
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ABSTRACT: In this review we summarize data obtained from animal studies showing that glucocorticoid hormones have a facilitatory role on behavioural responses to psychostimulant drugs such as locomotor activity, self-administration and relapse. These behavioural effects of glucocorticoids involve an action on the meso-accumbens dopamine system, one of the major systems mediating the addictive properties of drugs of abuse. The effects of glucocorticoids in the nucleus accumbens are site-specific; these hormones modify dopamine transmission in only the shell of this nucleus without modifying it in the core. Studies with corticosteroid receptor antagonists suggest that the dopaminergic effects of these hormones depend mostly on glucocorticoid, not on mineralocorticoid receptors. These data suggest that an increase in glucocorticoid hormones, through an action on mesolimbic dopamine neurons, could increase vulnerability to drug abuse. We also discuss the implications of this finding with respect to the physiological role of glucocorticoids. It is proposed that an increase in glucocorticoids, by activating the reward pathway, could counteract the aversive effects of stress. During chronic stress, repeated increases in glucocorticoids and dopamine would result in sensitization of the reward system. This sensitized state, which can persist after the end of the stress, would render the subject more responsive to drugs of abuse and consequently more vulnerable to the development of addiction.European Journal of Neuroscience 09/2002; 16(3):387-94. DOI:10.1046/j.1460-9568.2002.02089.x · 3.67 Impact Factor
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ABSTRACT: We evaluated plasma levels of DHEA-S and cortisol before and after treating ADHD patients with one of two medications: methylphenidate (n = 12) or bupropion (n = 10). Boys with ADHD (combined type) were evaluated with the Korean ADHD rating scale (K-ARS) and the computerized ADHD diagnostic system (ADS). All assessments were measured at baseline and repeated after 12 weeks. There were significant clinical improvements in both treatment groups as measured by K-ARS and ADS. DHEA-S levels increased from baseline to endpoint, but cortisol levels did not change significantly. This study suggests that both methylphenidate and bupropion increase plasma levels of DHEA-S in boys with ADHD.Child Psychiatry and Human Development 07/2008; 39(2):201-9. DOI:10.1007/s10578-007-0081-6 · 1.93 Impact Factor
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ABSTRACT: There is evidence that stress and glucocorticoids alter drug self-administration and mesolimbic dopamine (DA) activity in preclinical models. The primary purpose of this study was to test the hypothesis that glucocorticoids are associated with psychostimulant reinforcement and DA release in humans. In total, 16 healthy adults, ages 18-27 years, underwent two consecutive 90-min PET studies with high specific activity [11C]raclopride. The first scan was preceded by intravenous saline, and the second by intravenous amphetamine (AMPH 0.3 mg/kg). DA release was defined as the percent change in raclopride binding between the placebo and AMPH scans. Measures of subjective drug effects, plasma cortisol, and growth hormone (GH) were obtained. Findings showed that cortisol levels were positively associated with AMPH-induced DA release in the left ventral striatum (LVS) and the dorsal putamen. Subjects with higher cortisol responses to AMPH also reported more positive subjective drug effects than subjects with lower cortisol responses; no association was observed between cortisol levels and negative drug effects. Higher ratings of positive drug effects were also associated with greater DA release in the LVS, dorsal putamen, and dorsal caudate. A general lack of relationship was observed between GH responses to AMPH and DA release or subjective drug responses. Our findings provide evidence of interrelationships between glucocorticoid levels, subjective responses to IV AMPH, and brain DA release in humans. The results are consistent with those of preclinical studies, suggesting that individual differences in HPA axis function may influence vulnerability to alcohol and drug dependence in humans.Neuropsychopharmacology 05/2005; 30(4):821-32. DOI:10.1038/sj.npp.1300667 · 7.83 Impact Factor