Reactivity trial#

Thus, stress may enhance the salience of drug cues in cocaine-dependent women. Compared to cocaine-dependent men, cocaine-dependent women exhibited significantly greater craving and anxiety to drug cues that were preceded by yohimbine ( Moran-Santa Maria et al., 2014). Of note, compared to male rodents, female rodents exposed to the pharmacological stressor yohimbine exhibit greater stress potentiation of cue-induced cocaine seeking behavior ( Feltenstein et al., 2011). For example, stress potentiates cue-induced reinstatement of cocaine-seeking behavior in rodents ( Banna et al., 2010 Buffalari et al., 2009 Feltenstein et al., 2011 Liu et al., 2002). Taken together, these data suggest that among cocaine-dependent women, elevated progesterone attenuates craving responses to triggers of relapse and may impact use outcomes.Īccumulating research demonstrates an important interaction between stress and drug cues in relapse. Cocaine-dependent women with high progesterone levels reported significantly lower cue- and stress-induced craving and lower cue-induced anxiety than cocaine-dependent women with low progesterone levels. Sinha and colleagues (2007) examined the effects of endogenous progesterone levels on subjective responses to stress and drug cues using an autobiographical imagery paradigm. Protective effects of endogenous progesterone have also been found in clinical studies of cocaine-dependent women. Elevated levels of progesterone were associated with lower reinstatement responding for cocaine in intact freely-cycling female rodents ( Feltenstein et al., 2007). Studies investigating endogenous progesterone demonstrate similar effects.

Reactivity trial#

Human laboratory studies investigating exogenous progesterone administration have found attenuated cue-induced craving in cocaine-dependent individuals ( Fox et al., 2013), and reduced weekly cocaine use in post-partum cocaine-dependent women during a 12-week clinical trial ( Yonkers et al., 2014). In addition, progesterone treatment reduced cocaine-primed reinstatement in SH female rodents and in OVX female rodents that were treated with estrogen ( Anker et al., 2007). For example, exogenous progesterone administered to ovariectomized (OVX) and sham-operated (SH) female rodents attenuated self-administration of cocaine under long-access conditions, suggesting that progesterone attenuates drug binging behavior ( Larson et al., 2007).

Progesterone appears to have the opposite effects on stimulant-seeking behavior. For example, estrogen enhances the reinforcing effects of stimulants and may increase the vulnerability of women to drug craving and relapse ( Anker et al., 2007 Evans et al., 2002 Justice et al., 1999, 2000 Larson et al., 2007 Larson et al., 2005 Lile et al., 2007 White et al., 2002). Research focused on understanding the neurobiologic factors that underscore sex differences in drug craving and relapse could have important treatment implications for cocaine-dependent women.ĭata from clinical and preclinical studies suggests that ovarian hormones are important factors that contribute to sex and gender differences related to stimulant use. Thus, the effects of short and long-term drug use are particularly formidable for women. Cocaine-dependent women exhibit significant psychiatric, medical, and psychosocial dysfunction ( Brady et al., 1999 Najavits et al., 2008 Wong et al., 2002). In addition, cocaine-dependent women report higher rates of cocaine use and remain abstinent for shorter periods of time ( Griffin et al., 1989). For example, compared to men, women meet criteria for substance use disorders faster and enter treatment programs earlier than men ( Anglin et al., 1987 Hernandez-Avila et al., 2004 Westermeyer et al., 2000). There are significant sex differences in the development and symptomology of substance use disorders, including cocaine dependence.