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Related Experiment Videos

Endocrine withdrawal syndromes.

Ze'ev Hochberg1, Karel Pacak, George P Chrousos

  • 1Division of Endocrinology (Z.H.), Meyer Children's Hospital, Haifa 31096, Israel.

Endocrine Reviews
|August 16, 2003
PubMed
Summary
This summary is machine-generated.

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Hormone withdrawal syndromes share mechanisms with drug abuse, involving the hypothalamic-pituitary-adrenal axis and brain neurotransmitters. Gradual hormone tapering and stress prevention are key therapeutic strategies.

Area of Science:

  • Endocrinology
  • Neuroscience
  • Pharmacology

Background:

  • Hormone hypersecretion or high-dose therapy can lead to tolerance and dependence.
  • Discontinuation of hormone excess may trigger hormone deficiency and withdrawal syndromes.
  • Withdrawal symptoms can resemble those of drug abuse, suggesting shared underlying mechanisms.

Purpose of the Study:

  • To propose a unified endocrine withdrawal syndrome concept.
  • To elucidate the shared pathogenetic mechanisms of hormone withdrawal.
  • To outline therapeutic goals and strategies for managing endocrine withdrawal.

Main Methods:

  • Review of existing literature on hormone tolerance, dependence, and withdrawal.
  • Postulation of a unified endocrine withdrawal syndrome model.

Related Experiment Videos

  • Identification of key neuroendocrine pathways involved, including the HPA axis and central opioid peptides.

    • Main Results:

    • Hormone withdrawal syndromes share common pathogenetic links involving the hypothalamic-pituitary-adrenal axis, central opioid peptides, and brain noradrenergic and dopaminergic systems.
    • Long-term hormone adaptation may induce persistent molecular changes in intracellular signaling pathways.
    • Withdrawal symptoms can be mitigated by gradual hormone tapering, stress prevention, and antidepressant use.

    Conclusions:

    • A unified endocrine withdrawal syndrome is proposed, linking diverse hormonal withdrawal phenomena through shared neurobiological mechanisms.
    • Effective management involves easing withdrawal symptoms and facilitating patient weaning from hormonal excess.
    • Gradual hormone tapering, even after tumor removal, alongside stress management and antidepressants, is recommended.