Progesterone Attenuates the Stress Response in Individuals with Alcohol Dependence and Post-Traumatic Stress Disorder – A Pilot Study

Abstract

Objective

Evidence from laboratory studies suggests that progesterone may be effective in reducing stress and craving, and may improve cognitive performance in smokers and individuals with cocaine dependence. The objective of this study was to examine if progesterone would attenuate stress-induced craving, anxiety, affect and physiological measures, as well as improve stress-induced cognitive performance (processing speed and selective attention) in individuals diagnosed with alcohol use disorder (AUD) and post traumatic stress disorder (PTSD).

Methods

This laboratory study included (n = 13) participants who were diagnosed with current AUD and PTSD who were randomly assigned to recive either progesterone (200mg bid) or placebo in identical looking capsules for 3 days. On the fourth day they completed a laboratory session. In the morning of the test session, they received the last dose of medication and completed the rest of the laboratory procedures. The procedures included presentation in random order of personalized trauma and neutral scripts with relaxation in between. Main outcomes included measure of craving, anxiety, affect and cognitive performance.

Results

Consistent with other research, trauma scripts produced significantly greater increases in craving, anxiety and negative affect when compared with neutral scripts. Progesterone significantly reduced stress-induced symptoms of craving, anxiety, fear, anger and sadness but had no effect on positive emotions (joy, relaxation). Progesterone was effective in ameliorating stress-induced decreases in cognitive performance.

Conclusions

The findings from this study demonstrate that progesterone can be effective in reducing stress-induced craving, anxiety and negative affect in a laboratory setting in individuals with comorbid AUD and PTSD. Interestingly, progesterone also improved cognitive performance. These findings require replication in a larger clinical trial and may have implications for treatment among individuals with AUD and PTSD.

This study was registered as NCT02187224, at www.clinicaltrials.gov

Keywords:

• Progesterone
• PTSD
• AUD
• stress reactivity
• laboratory

Acknowledgments

The authors wish to thank Jane Weiner, RN for her important contribution to the success of this project and Amirah Bin-Mahfouz, BS for assistance in the preparation of this manuscript.

Disclosure statement

Dr. Petrakis has served as a consultant for Alkermes and Bioxcel over the past 3 years. No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by NARSAD #24330, VISN I Mental Illness Research Education and Clinical Center (MIRECC), National Center for PTSD (NCPTSD) Clinical Neurosciences Division. The funding sources had no role in the study design, collection, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the manuscript.