Neurocognitive and neurochemical responses in patients with anxiety and allostatic load: Beyond anxiolysis, can cognition be improved by alprazolam?

D`ALESSIO L, REMEDI C, SORIA CA, ROLDÁN EJA.; REMEDI C, SORIA C

Amsterdam

Congreso; 28th ECNP European Congress Neuropsychopharmacology; 2015

Asociación Europea de Neuropsicofarmacología

Purpose: Anxiety disorders commonly associates to chronic stress, and neuroticism. Supra-levels of cortisol and a hyperactive noradrenergic system can be found in these patients, having both factors been related to functionally-relevant effects on cerebral plasticity with neurocognitive and emotional implications. Nevertheless, the impact of stressful experiences on cognition and the role of the pharmacological treatment are still under research. The GABA-ergic drug alprazolam have known anxiolytic properties, but its influence on the stress system as well as the protracted adverse effects of BZD on cognition is still not well described. Therefore, within the GEMA project (Gador study of Stress Modulation by Alprazolam), two type of variables were assessed: A) the neurochemical response measuring salivary 3-methoxy-4hydroxyphenylglycol (MHPG) and cortisol levels, as useful markers for detecting changes in hypothalamic?pituitary?adrenal axis and in catecholamine metabolism as in daily practice conditions and B) the neuropsychological profile, in highly symptomatic patients treated with flexible doses of alprazolam.Methods: Fifty-four patients with anxiety (Hamilton scale/HAM-A), allostatic load (Crimmins and Seeman criteria) and neuroticism (NEO-FFI inventory), with a normal performance in the Folstein?s Mini-Mental State Examination were included. All were assigned on demand of alprazolam (0.25-1mg/t.i.d/12weeks) and underwent clinical, neurochemical (salivary MHPG and cortisol) and neurocognitive assessment. Verbal Fluency Test (VFT), Digit Span Test (DST) and Five Point Test (FPT), were determined before and during treatment (0, 2 and 12 weeks). Patients were divided in 2 groups, those with moderate to severe anxiety (MSA) (n= 28, 16-30 points in HAM-A), and with very severe anxiety (VSA) (n=26, > 30 points HAM-A). Student´s T test, ANOVA and Pearson correlations were determined by SPSS program.Results: Anxiety scores, salivary MHPG and cortisol levels were significantly reduced at week 2, and continue steady up to week 12 of treatment (p