Metoclopramide as pharmacological tool to assess vasopressinergic co-activation of the hypothalamus-pituitary-adrenal (HPA) axis: a study in healthy volunteers

European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology
G E JacobsJ M A van Gerven

Abstract

The synthetic vasopressin (AVP) analogue desmopressin (dDAVP) has been used as pharmacological function test to quantify vasopressinergic co-activation of the hypothalamus-pituitary-adrenal (HPA) axis in the past. Such exogenous vasopressinergic stimulation may induce confounding cardiovascular, pro-coagulatory and anti-diuretic effects and low endogenous corticotrophin-releasing-hormone (CRH) levels may limit its potential to reliably assess co-activation. Alternatively, the dopamine-2-(D2)-antagonist metoclopramide is believed to induce co-activation indirectly by releasing endogenous AVP. We investigated this indirect co-activation with metoclopramide under conditions of low and enhanced endogenous CRH release in healthy volunteers. A randomized, double-blind, placebo-controlled, four-way crossover study was performed in 12 healthy males. CRH release was induced by administering an oral 5-hydroxytryptophan (5-HTP) 200 mg function test. Co-activation was investigated by administering metoclopramide 10mg intravenously around the expected maximal effect of 5-HTP. The neuroendocrine effects were compared to those of metoclopramide alone, the 5-HTP test alone and matching placebo. Metoclopramide safely induced HPA-axis activation...Continue Reading

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Aug 23, 2008·Journal of Psychopharmacology·G E JacobsJ M A van Gerven

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Citations

Nov 28, 2013·The Journal of Clinical Endocrinology and Metabolism·Ferdinand RoelfsemaJohannes D Veldhuis
May 15, 2013·The Journal of Clinical Endocrinology and Metabolism·Narelle C HadlowJohn P Walsh
Nov 5, 2015·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Steven R WainwrightLiisa Am Galea

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