Exposure therapy is an effective cognitive-behavioral treatment for patients with obsessive-compulsive disorder (OCD). However, a further amelioration of symptoms by additional drugs that enhance extinction learning is desirable. An interesting candidate is pregnenolone, which positively modulates NMDA and GABAA receptors in preclinical studies and influences amygdala and prefrontal activity in humans. We present pilot data showing high acceptance and good tolerability of pregnenolone given 2 h before exposure sessions in OCD patients. As per our interim analyses, exposure treatment resulted in significantly improved main outcome parameters, but no effects of pregnenolone vs. placebo pretreatment were detectable thus far.
Background: During stress, arginine vasopressin (AVP) and corticotropin-releasing hormone (CRH) can act as potent hypothalamic stimulators of the hypothalamic pituitary adrenocortical (HPA) axis. Recently, plasma CT-proAVP, also termed copeptin, was found to be a stable and sensitive surrogate marker for AVP release. A valid assessment of both CRH and copeptin in cerebrospinal fluid (CSF) might directly quantify an individual's current stress level. Here we investigated how concentrations of CRH and copeptin in CSF alter during insulininduced hypoglycemia test (IHT) -which has been shown to activate both hypothalamic AVP and CRH -and hypothesized an increase of both.
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