Low-dose hydrocortisone replacement improves wellbeing and pain tolerance in chronic pain patients with opioid-induced hypocortisolemic responses. A pilot randomized, placebo-controlled trial

Highlights • This is the first RCT of glucocorticoid replacement in CNCP with hypocortisolemia. • Low-dose hydrocortisone improves vitality and pain in LTOT users over placebo. • Cold pressor testing can detect subtle HPA-axis impairment.

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Bibliographic Details
Published in:	Psychoneuroendocrinology Vol. 56; pp. 157 - 167
Main Authors:	Nenke, Marni A, Haylock, Clare L, Rankin, Wayne, Inder, Warrick J, Gagliardi, Lucia, Eldridge, Crystal, Rolan, Paul, Torpy, David J
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-06-2015
Subjects:	Aged Analgesics, Opioid - adverse effects Analgesics, Opioid - therapeutic use Anti-Inflammatory Agents - therapeutic use Blood Pressure - drug effects Chronic pain Chronic Pain - drug therapy Chronic Pain - psychology Cross-Over Studies Double-Blind Method Endocrinology & Metabolism Female Hormone Replacement Therapy - methods Humans Hydrocortisone - adverse effects Hydrocortisone - deficiency Hydrocortisone - therapeutic use Hydrocortisone replacement Hypocortisolemia Male Opioid Pain Measurement - drug effects Pilot Projects Psychiatry Quality of Life Treatment Outcome Opioid Hydrocortisone replacement Chronic pain Hypocortisolemia
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Summary:	Highlights • This is the first RCT of glucocorticoid replacement in CNCP with hypocortisolemia. • Low-dose hydrocortisone improves vitality and pain in LTOT users over placebo. • Cold pressor testing can detect subtle HPA-axis impairment.
Bibliography:	SourceType-Scholarly Journals-1 ObjectType-Feature-4 ObjectType-Undefined-1 ObjectType-News-2 content type line 23 ObjectType-Article-3
ISSN:	0306-4530 1873-3360
DOI:	10.1016/j.psyneuen.2015.03.015