Prolactin Serum Levels During Alcohol Withdrawal Are Associated With the Severity of Alcohol Dependence and Withdrawal Symptoms

Authors

  • Julia Wilhelm,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Annemarie Heberlein,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Deniz Karagülle,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Michael Gröschl,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Johannes Kornhuber,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Rafael Riera,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Helge Frieling,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Stefan Bleich,

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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  • Thomas Hillemacher

    1. From the Department of Psychiatry (JW, AH, DK, HF, SB, TH), Social Psychiatry and Psychotherapy, Center for Addiction Research, Medical School Hanover, Germany; Department of Psychiatry and Psychotherapy, University Hospital Erlangen (JW, AH, JK, HF, SB, TH), Germany; Department of Pediatrics, University Hospital Erlangen (MG), Germany; and Clinic for Psychiatry, Psycho-therapy and Psychosomatic Medicine (RR), Kutzenberg, Germany.
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Reprint requests: Thomas Hillemacher, MD, Department of Psychiatry, Social Psychiatry and Psychotherapy; Center for Addiction Research, Medical School Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Tel: +49 511 5326561; Fax: +49 511 5322405; E-mail: hillemacher.thomas@mh-hannover.de

Abstract

Background:  Prolactin serum levels have been described to be elevated during alcohol withdrawal in alcohol-dependent patients and normalize during abstinence. Alterations in prolactin levels may reflect disturbances of dopaminergic neurotransmission which is of crucial importance for alcohol-seeking behavior.

Methods:  In this longitudinal observational study, we investigated prolactin serum levels in 99 male patients during the first 14 days of alcohol withdrawal and early abstinence and in 43 healthy controls. To assess the severity of alcohol dependence, the extent of withdrawal symptoms, craving, depressive symptoms, and anxiety, we employed a structured interview including psychologic measurements.

Results:  Prolactin serum levels were elevated during the whole study period in alcohol-dependent patients compared to the healthy control group. Prolactin levels at admission (first day of alcohol withdrawal) were associated with the severity of alcohol withdrawal (CIWA-Ar) and of alcohol dependence (SESA) but not with the other assessed psychologic parameters.

Conclusions:  The presented findings confirm that prolactin is significantly elevated in alcohol-dependent patients during alcohol withdrawal and early abstinence, not showing a rapid decline after cessation of drinking. The association with the severity of withdrawal and dependence may reflect at least partially the individual alterations in the dopaminergic and glutamatergic pathways.

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