Attenuation of alcohol withdrawal syndrome and blood cortisol level with forced exercise in comparison with diazepam.
AbstractRelieving withdrawal and post-abstinence syndrome of alcoholism is one of the major strategies in the treatment of alcohol addicted patients. Diazepam, chlordiazepoxide, and topiramate are the approved medications that were used for this object. To assess the role of non-pharmacologic therapy in the management of alcohol withdrawal syndrome, we analyzed effects of forced exercise by treadmill on alcohol dependent mice as an animal model. A total of 60 adult male mice were divided into 5 groups, from which 4 groups became dependent to alcohol (2 g/kg/day) for 15 days. From day 16, treatment groups were treated by diazepam (0.5mg/kg), forced exercise, and diazepam (0.5 mg/kg) concurrent with forced exercise for two weeks; And the positive control group received same dose of alcohol (2 g/kg/day) for two weeks. The negative control group received normal saline for four weeks. Finally, on day 31, all animals were observed for withdrawal signs, and Alcohol Total Withdrawal Score (ATWS) was determined. Blood cortisol levels were measured in non-fasting situations as well. Present findings showed that ATWS significantly decrease in all treatment groups in comparison with positive control group (P<0.05 for groups received diazepam and treated by forced exercise and P<0.001 for group under treatment diazepam + forced exercise). Moreover, blood cortisol level significantly decreased in all treatment groups (P<0.001). This study suggested that forced exercise and physical activity can be useful as adjunct therapy in alcoholism and can ameliorate side effects and stress situation of withdrawal syndrome periods.
Smith L, Watson M, Gates S, et al. Meta-analysis of the association of the Taq1A polymorphism with the risk of alcohol dependency: a HuGE gene-disease association review. Am J Epidemiol 2008;167(2):125-38.
Carmen B, Angeles M, Ana M, et al. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction 2004;99(7):811-28.
Ferri M, Amato L, Davoli M. Alcoholics Anonymous and other 12-step programmes for alcohol dependence. Cochrane Database Ssyst Rev 2006;3(2):CD005032.
Krystal JH, Cramer JA, Krol WF, et al. Naltrexone in the treatment of alcohol dependence. N Engl Jl Medi 2001;345(24):1734-9.
Addolorato G, Leggio L, Abenavoli L, et al. Baclofen in the treatment of alcohol withdrawal syndrome: a comparative study vs diazepam. Am J Med 2006;119(3):276. e13-8.
Muzyk AJ, Leung JG, Nelson S, et al. The Role of Diazepam Loading for the Treatment of Alcohol Withdrawal Syndrome in Hospitalized Patients. Am J Addict 2013;22(2):113-8.
Bruijnzeel AW, Small E, Pasek TM, et al. Corticotropinreleasing factor mediates the dysphoria-like state associated with alcohol withdrawal in rats. Behav Brain Res 2010;210(2):288-91.
Breese GR, Sinha R, Heilig M. Chronic alcohol neuroadaptation and stress contribute to susceptibility for alcohol craving and relapse. Pharmacol Ther 2011;129(2):149-71.
Huang MM, Overstreet DH, Knapp DJ, et al. Corticotropin-releasing factor (CRF) sensitization of ethanol withdrawal-induced anxiety-like behavior is brain site specific and mediated by CRF-1 receptors: relation to stress-induced sensitization. J Pharmacol Exp Ther 2010;332(1):298-307.
Stalder T, Kirschbaum C, Heinze K, et al. Use of hair cortisol analysis to detect hypercortisolism during active drinking phases in alcohol-dependent individuals. Biol Psychol 2010;85(3):357-60.
Bokhan N, Gavrilova V, Gusev S, et al. 1581–Steroid hormones levels in alcohol dependent patients under conditions of social isolation. Eur Psychiatr 2013;28(1):1.
Brown RA, Abrantes AM, Read JP, et al. A pilot study of aerobic exercise as an adjunctive treatment for drug dependence. Ment Health Phys Act 2010;3(1):27-34.
Smith MA, Lynch WJ. Exercise as a potential treatment for drug abuse: evidence from preclinical studies. Front Psychiatry 2011;2:82.
Williams DM, Dunsiger S, Whiteley JA, et al. Acute effects of moderate intensity aerobic exercise on affective withdrawal symptoms and cravings among women smokers. Addict Behav 2011;36(8):894-7.
Lynch WJ, Peterson AB, Sanchez V, et al. Exercise as a novel treatment for drug addiction: A neurobiological and stage-dependent hypothesis. Neurosci Biobehav Rev 2013:37(8):1622-44.
Forbes A, Cooze J, Malone C, et al. Effects of intermittent binge alcohol exposure on long-term motor function in young rats. Alcohol 2013;47(2):95-102.
Gatch MB. Effects of Benzodiazepines on Acute and Chronic EthanolInduced Nociception in Rats. Alcohol Clin Exp Res 1999;23(11):1736-43.
Erden B, Ozdemirci S, Yildiran G, et al. Dextromethorphan attenuates ethanol withdrawal syndrome in rats. Pharmacol Biochem Behav 1999;62(3):537-41.
Albeck DS, Sano K, Prewitt GE, et al. Mild forced treadmill exercise enhances spatial learning in the aged rat. Behav Brain Res 2006;168(2):345-8.
Brown RA, Abrantes AM, Read JP, et al. Aerobic Exercise for Alcohol Recovery Rationale, Program Description, and Preliminary Findings. Behav Modif 2009;33(2):220-49.
Amato L, Minozzi S, Vecchi S, Davoli M. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev 2010;3:CD005063.
Martinotti G, Di Nicola M, De Vita O, et al. PW01-237- Low-dosage topiramate in alcohol dependence: a randomized, double-blind, placebo-controlled trial. EurPsychiatr 2010;25(Suppl 1):1665.
Krogh J, Nordentoft M, Sterne JA, et al. The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry 2011;72(4):529-38.
Tesarz J, Schuster AK, Hartmann M, et al. Pain perception in athletes compared to normally active controls: A systematic review with meta-analysis. Pain 2012;153(6):1253-62.
Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm 2009;116(6):777-84.
Fuss J, Ben Abdallah NMB, Vogt MA, et al. Voluntary exercise induces anxietylike behavior in adult C57BL/6J mice correlating with hippocampal neurogenesis. Hippocampus 2010;20(3):364-76.
Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. T Int J Psychiatry Med 2011;41(1):15-28.
Greenwood BN, Foley TE, Le TV, et al. Long-term voluntary wheel running is rewarding and produces plasticity in the mesolimbic reward pathway. Behav Brain Res 2011;217(2):354-62.
Vučcković MG, Li Q, Fisher B, et al. Exercise elevates dopamine D2 receptor in a mouse model of Parkinson's disease: in vivo imaging with [18F] fallypride. Mov Disord 2010;25(16):2777-84.
Boecker H, Tölle TR, Valet M, et al. Effects of Aerobic Exercise on Mood and Human Opioidergic Activation Measured by Positron Emission Tomography. Funct Neuroimag Exerc Sport Sci 2012;:499-510.
Sinha R, Fox HC, Hong K-iA, et al. Effects of adrenal sensitivity, stress-and cue-induced craving, and anxiety on subsequent alcohol relapse and treatment outcomes. Arch Gen Psychiatry 2011:68(9):942-52.
Roberto M, Cruz MT, Gilpin NW, et al. Corticotropin Releasing Factor–Induced Amygdala Gamma- Aminobutyric Acid Release Plays a Key Role in Alcohol Dependence. Biol Psychiatry 2010;67(9):831-9.