Issue 175 Item 14 Alprazolam Curbs Responses to Hypoglycemic Stress

Alprazolam, a benzodiazepine that activates GABA receptors, inhibits the release of acth, cortisol and other responses to insulin-induced hypoglycemic stress.

Thus, to further clarify neuroendocrine actions, the researchers studied eight healthy volunteers. The volunteers were subjected to two separate insulin-induced hypoglycemic episodes that were preceded by administration of alprazolam or placebo.
In both sessions, the subjects showed typical hypoglycemic symptoms, including hunger, sweating and palpitations, but alprazolam pretreatment attenuated these effects.

After placebo pretreatment, examination of blood samples showed that insulin induced clear increases in ACTH, GH, adrenaline and noradrenaline.

Alprazolam pretreatment significantly reduced the peak ACTH response, the GH response and the adrenaline response. It also lowered basal noradrenaline but did not otherwise significantly affect the noradrenaline increase.

The researchers conclude that the findings "point towards a relevant role of GABAergic pathways and benzodiazepine/GABA receptors in pituitary and adrenomedullary responses" to hypoglycemia."
Clin Endocrinol 2003;59:314-320.

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