The hypothalamic-pituitary-adrenal axis (HPA) is restrained by activation of gamma-amino-butyric acid receptors. Alprazolam (APZ) and dehydroepiandrosterone (DHEA) are purported to be gamma-amino-butyric acid agonists and antagonists, respectively.Our objective was to examine the effects of APZ and DHEA alone and in combination on HPA axis activity.This was a double-blind, crossover, placebo-controlled study.The study setting was the general community.Subjects consisted of 15 men (age, 20-45 yr) with a body mass index of 20-25 kg/m2.DHEA (100 mg/d) or placebo was given for 4 wk, followed by a 2-wk washout; participants ingested 0.5 mg APZ or placebo 10 and 2 h before high-intensity exercise.We measured basal and exercise-induced ACTH, arginine vasopressin (AVP), cortisol, DHEA, and GH responses. It was hypothesized that DHEA would enhance and APZ would blunt exercise-induced ACTH and cortisol release.DHEA significantly increased the AVP response to exercise (P < 0.01). APZ treatment significantly increased basal GH and blunted plasma cortisol, ACTH, AVP, and DHEA responses to exercise (P < 0.05). DHEA and APZ in combination significantly increased the GH response to exercise (P < 0.01).DHEA may alter a subset of receptors involved in AVP release. Together DHEA and APZ may up-regulate GH during exercise by blunting a suppressive (HPA axis) and potentiating an excitatory (glutamate receptor) system.
Leslie J. Crofford, Stanley R. Pillemer, Konstantine T. Kalogeras, Joseph M. Cash, David Michelson, Mitchel A. Kling, Esther M. Sternberg, Philip W. Gold, George Chrousos, Ronald L. Wilder
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