Gender differences in cardiovascular and corticoadrenal response to stress and drug cues in cocaine dependent individuals.

RATIONALE: Extensive research suggests that gender may affect neuroendocrine and cardiovascular arousal mechanisms underlying biological responses to stress.

OBJECTIVE

To examine the impact of gender on response to stress and to drug-cue exposure in treatment-seeking cocaine abusers.

METHODS

Fifty recently abstinent cocaine dependent individuals (25F/25M), who were matched on cocaine use history, were exposed to a brief guided-imagery procedure that involved imagining a recent personal stressful situation, a personal drug-related situation and neutral-relaxing situation, one imagery per session, presented in random order. Subjective craving and anxiety, cardiovascular measures and plasma adrenocorticotrophic hormone (ACTH), cortisol and prolactin were assessed.

RESULTS

Males showed significantly higher levels of ACTH, cortisol, and SBP, both at baseline and following all three imagery conditions. Females showed significantly higher basal heart rate and prolactin, although no gender differences were observed following imagery. No gender differences were seen in subjective anxiety or cocaine craving.

CONCLUSIONS

Results indicate significant gender differences in baseline sensitivity and subsequent variations in hypothalamus-pituitary-adrenal (HPA) and cardiovascular response to imagery challenge. Such gender-specific responses could have implications for the development of pharmacological treatments that address stress and drug-cue-related relapse in cocaine-abusing individuals.