Endorphins and cortisol. The role of endorphins in the human body Functions of endorphins

Hi all! Today will be perhaps the most famous substance, after serotonin, that is produced in our brain. There are a lot of rumors around endorphins; articles regularly appear on the Internet about increasing these same endorphins. Our project has not yet touched on this connection, let’s figure out what’s what!

In common parlance, endorphins are called molecules of happiness, as are serotonin and dopamine.

Endorphins- these are substances that are more neurotransmitters, but not yet hormones. The main one among endorphins is beta-endorphin. Produced in the nervous system and less in the immune system. Endorphins are associated with euphoria, a state of supreme bliss when there are no problems, no disappointments, but only positive feelings to the superlative degree. But this is not their main action; let’s move on to the mechanisms of operation.

Mechanism of action

1. Pain.

So remember any shock situation when you received damage. Maybe it's falling off a bike or some kind of martial arts performance or hitting your little finger on a doorway. Moreover, when you expected damage, seeing how the asphalt was approaching while falling from your bicycle, a surge of adrenaline with norepinephrine appeared in your nervous system, as when taking it. And at the moment of falling, sometimes you don’t even feel pain. Something starts to hurt later, when the situation has passed. This is what the body’s protective reaction to stress looks like: in order to survive and emerge victorious, it would be good not to worry about the fact that you are in pain somewhere. In the case of a sudden injury, such as a burn, there is a sharp pain at the beginning, and then it goes away. And here endorphins are already working.

This is an important difference, adrenaline and norepinephrine work better for a short period of time, here and now, to relieve pain, survive, crush, beat or run away, and endorphins help when the stress has passed and even the pulse is normal.

Typically, endorphins block weak pain signals, like yesterday's scratch on the arm, and let strong ones through, otherwise we would all suffer from a small bruise until it goes away.

How does it work:

We are accustomed to the fact that a neurotransmitter is produced by a neuron, then attaches to its receptors on the surface of another neuron and some tangible effect occurs, depending on the type of neurotransmitter, if it is Anandamide, then it is more likely to slow down thinking, if Glutamate, it is to accelerate.

When we talk about endorphins, the action occurs not with the receptors, but with the neuron itself. Beta-endorphin blocks pre- and post-synaptic nerve endings, something like anesthesia. The neurotransmitter GABA immediately declines, which has no need to further slow down the already slow nervous system. Then the balance changes in other neurotransmitters. The production of the protein “Substance P”, which is also involved in the transmission of pain, is inhibited. In general, neurons slow down the transmission of signals, less GABA and Substance P.

It has been proven that the more beta-endorphins in the blood, the easier postoperative pain is tolerated ( Link 1).

1. Euphoria.

It is known that the most dangerous drug in the world, Heroin, is addictive from the first use and is structurally similar to endorphins. Simulates their action. And it would be strange if it was taken for pain relief alone. So what is the specific euphoria?

First of all, on my own beta-endorphin is already able to reduce pain and anxiety.

Secondly, as already mentioned, an internal decrease in GABA introduces an imbalance in the neurotransmitter system and the first consequence is an increase in our beloved Dopamine. There is a surge, hyperactivation ( 2 ). This results in a feeling of lightness and pleasure from life.

1. Depersonalization

A term used in psychology. It means perceiving one’s own actions as if from the outside. For example, you are drinking tea, but it seems that you are not in control of yourself. With an increase in endorphins, a person dissociates a little, depersonalizes ( 3 ).

How to increase endorphins

- Laughter. You will be able to endure pain twice as long if you have a good laugh. In a 2012 experiment, they decided to measure the pain threshold of different people in different emotional states and it turned out that a great mood is not only pleasant in itself, but also makes it easier to tolerate pain. And here we are not talking about 10-15%, the differences reach hundreds of percent. It turned out that laughter in a group is much more effective than laughter alone, but even alone, even fake laughter, already increases endorphins. ( 4 ). So the practical conclusion: if you feel bad or in pain, don’t spoil everyone else’s mood, but force yourself to laugh, ideally when this happens in a group.

- Sports. And here is an important condition: you don’t need such loads that you turn pale, feel sick or can barely drag your feet, but ones that make you tired but happy! ( 5 ). By the way, when playing sports in a group, endorphins increase more than when playing alone ( 6 ). Try playing team games on the sports fields. This will also improve your social skills.

- Music. Everyone has different tastes, some listen to Aerosmith, others Prorgessive House. It is important that you like the music, and not specifically Mozart. Try starting your day or working at the computer with music that is pleasant to you ( 7 ).

First of all, do the opposite of the previous advice: listen to bad music, lock yourself away from everyone and watch hard dramas. Reduce. From pharmacology - opioid receptor blockers, such as Naloxone, for example. This substance does not prevent endorphins from being produced, but it does prevent it from attaching to receptors; there are no effects.

Result:

— Endorphins The body needs them primarily to block pain signals and only then for a good mood. Helps to depersonalize a little.

— They work through anesthesia of some neurons, a decrease in GABA and an increase in Dopamine.

— Laughter, music and sports greatly stimulate endorphins. The ideal natural boost is to have a good laugh after a pleasant workout in good company with your favorite music in the background.

Well, without bitterness, sweetness is insipid - remember this when you are in a less than euphoric mood! Good luck and see you soon!

Against the backdrop of the fitness boom, the phrase “during running, endorphins are released - hormones of happiness, our internal drugs” are used more and more often. Actually this is not true. Firstly, when running, not only endorphins are formed, but also endogenous cannabinoids, as revealed in a recent neurobiological study. Secondly, endorphins are not hormones. Third, although the structure of endorphin molecules is indeed similar to “real” drugs like morphine and heroin, their narcotic effect has not been proven.

Everything is interconnected

Mass consciousness is slowly accepting the idea that emotions are controlled by invisible substances secreted by equally invisible (to the naked eye) brain cells and something like that.

• Dopamine- this is the “pleasure molecule”,
• oxytocin- this is the “attachment hormone”, and so on.

In reality, the picture is much more complex.

• Firstly, neurotransmitters and hormones are still different things. The former are secreted by some neurons and transmitted to others through a special cell contact - the synapse. Synapses can be formed either by two neurons or by a neuron and a muscle cell.

But the second ones - hormones- first of all they enter the blood and only then to the target cells (which do not have to be neurons or muscle cells). These targets can be located in any organ.

We almost never see the net effect of a single neurotransmitter, and there are several reasons for this.

• Firstly, the effect of a neurotransmitter on a specific cell depends on which receptors (special protein molecules that can physically or chemically bind to the neurotransmitter and change their properties in response to the formation of this bond) are located on the surface of this cell.
• For almost every neurotransmitter, there are several types of receptors. Activation of receptors of different types has different effects on the physiology and behavior of the body - to the point that the responses of different cells to the same neurotransmitter are directly opposite. Secondly, neurotransmitters can influence not only “their” receptors, but also “foreign” ones, increasing or decreasing the susceptibility of the latter. Finally, most cells have receptors for several neurotransmitters at once.

Runner's Euphoria

A common feature of all endorphins and endocannabinoids is a wide spectrum of action. Compared to traditional neurotransmitters such as glutamate, gamma-aminobutyric acid, acetylcholine and the like, they have a more global effect. Therefore, they are sometimes called neuromodulators rather than neurotransmitters. Endogenous cannabinoids and endogenous opiates, like conventional neurotransmitters, are released by one of the two neurons in the synapse. The difference is that their action is directed against the course of the main chemical signal. Traditional transmitters are released by the presynaptic neuron and received by the postsynaptic neuron. With endocannabinoids (and often endogenous opiates), the opposite is true. Endogenous opiates and endogenous cannabinoids act on the presynaptic cell - a neuron within the synapse that releases traditional signaling substances. As a result of this effect, the presynaptic neuron begins to release more or less neurotransmitter than before.

The last of these principles is often forgotten.

An example of this is the story of runner's euphoria: a condition where people who have run or swam a significant distance feel happier and calmer after exercise. Some people experience decreased sensitivity during the “runner’s euphoria”, and some even feel that their consciousness is almost separated from their body.

So, at the beginning of September 2015 in the magazine Proceedings of the National Academy of Sciences (PNAS) An article was published that showed that after running on a wheel, mice become calmer and less susceptible to pain, and this effect occurs due to the activation of endocannabinoid receptors.

Endocannabinoids- these are substances that are similar in structure and action to the active components of marijuana, only they are produced by neurons in the brain, hence the prefix “endo-”. And calm and pain relief are just two manifestations of a runner’s euphoria.

News outlets circulated the PNAS article because it presented a supposedly new fact:

“runner's high” is not caused by the action of endogenous opiates (these include endorphins - endogenous morphines, which are produced by brain cells and act like morphine and heroin), as was believed a couple of decades before, but by the action of endogenous cannabinoids.

The 2015 discovery could have influenced the development of pharmacology, if not for a couple of circumstances.

• Firstly Scientists have previously reported that endocannabinoids are involved in creating the “runner's high.”
• Secondly, an increase in mood and pain threshold after physical activity is caused by both cannabinoids and opiates, and according to journalists, it turned out that only one thing works. In fact, there is something of a division of labor between the “internal drugs”: endogenous opiates mainly reduce muscle pain that occurs after exercise, and endogenous cannabinoids are more likely to reduce anxiety. Given that the study discussed was conducted on mice and not on humans, it was not possible to assess the feeling of happiness after training: we cannot reliably assess the level of happiness in rodents.

Endogenous opiates: drugs or not?

Let's define what a drug is. The WHO considers it "a chemical agent that causes stupor, coma, or insensitivity to pain." In this sense, endogenous opiates most likely fit the definition of a drug, because the main purpose of their action in the body is to reduce the sensation of pain.

“Narcotic drugs are substances of synthetic or natural origin, drugs, plants included in the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation, including the Single Convention on narcotic drugs in 1961".

Beta-endorphin and other endogenous opiates are not on the mentioned list.

Rice. 1. Beta-endomorphin molecule. Image: Diomedia.

Well, without official language, a drug is any substance that changes behavior and mood and on which a person becomes dependent. Let's start with behavior change. The euphoric effect is attributed to endorphins, but it also manifests itself from taking high doses of morphine and heroin - recognized drugs that themselves are not related to endorphins, but are only similar to them in structure. But the direct connection between endorphins themselves and the feeling of happiness in people has not yet been proven. Moreover, long-standing studies in rats and humans show that morphine and one of the most common endorphins, beta-endorphin, have different effects on the body at similar dosages.

For example, in a 1977 study, three cancer patients and two patients were given intravenous injections of either beta-endorphin, morphine, or just saline after nine days of abstinence from methadone. Although neither the subjects nor those who monitored their behavior after the injections knew which of the three substances was in the syringes, the effects of morphine and beta-endorphin were all easily distinguished. I must say that

everyone who took beta-endorphin felt better: For some, the pain went away, while others temporarily stopped experiencing symptoms of withdrawal symptoms.

These and newer results suggest that beta-endorphin could theoretically be used as a pain reliever, especially since it has no significant side effects.

Other work done on rats showed that beta-endorphin and morphine did not change behavior in male rats in the same way. Experimental animals were introduced to either a female ready for mating or a castrated male. In the first case, males, not under the influence of any substances, demonstrate sexual behavior, and in the second - social behavior. So, intravenous administration of 0.5–1 milligrams of morphine made the experimental subjects forget about mating and communication, and the introduction of the same amount of beta-endorphin increased the desire to interact with a castrated male and decreased interest in the female. Because of this, the authors suspected that morphine and beta-endorphin act either on different types of receptors or in different parts of the brain. This suspicion is confirmed by later studies.

Is there a dependency?

As for addiction to beta-endorphin and other endogenous opiates, no one has really studied it (or created it). Basically, the researchers injected beta-endorphin into animals that were already on morphine. Beta-endorphin relieved such animals from the symptoms of withdrawal syndrome, but it was impossible to say whether it was addictive: as a rule, this endogenous opiate was administered once or twice. Well, then, in order to study addiction, it is necessary to show what will happen to the body if it stops receiving regular doses of endogenous opiates. It is difficult to find such an organism, because normally everyone produces opiates. You can, of course, temporarily “turn off” one or more genes responsible for the production of beta-endorphin and similar substances. The problem is that beta-endorphin is not synthesized from scratch, but is “split off” from one large protein, other “fragments” of which also affect physiology and behavior. If we block the production of beta-endorphin, we automatically disrupt the production of several other important molecules. It turns out that in this case it will not be possible to look at the net “withdrawal effect” of beta-endorphin.

Rice. 2. Structural correspondences between opioid peptide and morphine. Image: Dannybalanta.

Another option is to block the receptors that perceive opiates. Such studies have been carried out, but since these receptors respond to both morphine and beta-endorphin, it cannot be argued that the effects obtained in them (lack of analgesic effect of morphine, increased pain sensitivity and immunity to other drugs) are caused only by the “withdrawal” of endorphins.

In general, endogenous opiates cannot be completely removed from the body, unlike real opioid drugs. But you can wait until the level of beta-endorphin in the blood decreases on its own. This is possible in those organisms whose physiology changes cyclically - in women. In 14 subjects, the content of beta-endorphin in the blood was measured every day from the seventh day of the menstrual cycle to the twenty-fourth. It turned out that the closer to the onset of menstruation, the lower the concentration of this endogenous opiate in the blood. The more beta-endorphin levels fell, the more pronounced premenstrual syndrome was in the woman. So perhaps endogenous opiate withdrawal syndrome does exist.

Endorphin helps alcoholism

Still, endogenous opiates are involved in the formation of addictions. Only the dependence will not be on them, but on other substances - like food and alcohol. For example, if you cause stress in a rat by tugging at the tip of its tail for several days in a row, it will “eat up” this stress - of course, provided that there is enough food. If, ten days after the onset of stress, an animal is given an opiate receptor blocker, it will behave as if it had recently stopped taking morphine. And drinking alcohol increases the release of endogenous opiates in the brain. This is especially true for heavy alcoholics. Apparently, different endorphin susceptibility to alcohol determines who will become addicted to it and who will drink only on holidays.

Rice. 3. Image: Roadnottaken / Wikipedia.

Speak correctly

So, it turns out that we have too little evidence to classify endogenous opiates as drugs. They also shouldn’t be called hormones of joy and happiness: hormones are a bit of a different story, and the appearance of joy and happiness from endogenous opiates still needs to be found and proven. Now it is best to think of endogenous opiates as another type of neurotransmitter like glutamate - only a little more powerful.

The human body is an extremely complex system, in which hormones play a huge role. They control our condition, well-being, mood and various physical indicators.

Endorphin is one of these hormones, and awareness of its effect on a person is very important for that person.

General information

Endorphin is primarily a hormone. To be more precise, this name refers to a group of complex peptide (polypeptide) chemical compounds that can influence the feeling of pain and the general emotional state of a person. It is also called the “hormone of joy,” although this is not entirely true - to achieve a feeling of happiness and fun, the cumulative effect of a much larger number of hormones is necessary (like serotonin, which is also called “hormones of joy”), and endorphin is not the most important of them.

The effect of endorphins on the body is similar to the effect of opiates (morphine, heroin, opium), but do not be afraid of this - narcotic opiates artificially cause a feeling of joy and satisfaction, and therefore the brain quickly gets used to them and they replace the natural hormones of happiness, and in the case If you refuse to take it, withdrawal syndrome manifests itself, that same “withdrawal.” So there is nothing scary about the natural effect of endorphins on the body.

How is it synthesized in the body?

This hormone is produced in our brain, namely in the lower cerebral appendage, also known as the pituitary gland. also called a small rounded appendage that is located on the lower surface of the brain. It is the most important organ of the endocrine system. In the pituitary gland, endorphins are produced from beta-lipotrophin, which it creates itself, after which the hormone enters the blood.

Basically, endorphins are synthesized in response to stress acquired by the body, which is a kind of protective reaction of our body. Research shows that active production also occurs when experiencing pain, being in competitions or participating in various combat activities (from a street fight to war) - this helps to mobilize forces as quickly as possible and pay less attention to pain, as a result of which activity and chances increase for survival.

Main functions of the hormone

Like any hormone, endorphins have a direct impact on our state, in this case - emotional, psychological and mental. Our behavior in any situation depends on it, whether we feel angry and aggressive, feel pain, or, on the contrary, feel relaxed and calm.

For example, during a fight, the increased production of endorphins helps to feel the blows received less by dulling the sensation of pain, and this also slightly increases the reaction, which increases the chances of winning the fight.

Helping to overcome stress without developing various diseases and disorders is also an important function of this hormone.

Endorphins can also improve your mood. For example, its content in the blood increases when listening to the music you like or doing your favorite things.

It is also believed that endorphins control the work of the endocrine system, which is not surprising, because the pituitary gland that produces them is the most important organ of this system.

What is the threat of a shortage?

The intensity of hormone production and, accordingly, its content in the blood can fluctuate in different life situations. A modern person is likely to encounter one serious problem - a lack of endorphins. There can be many reasons for this: excessive consumption of substances and products that lead to a feeling of artificial satisfaction, such as drugs, alcohol, sweets (in this case, the person will probably start consuming these products or substances in large quantities, but this will not do any good for him will bring, but will not increase the level of the hormone we need so much), as well as serious disruptions in the production of this hormone, such as hormonal imbalances.

A person with an insufficient level of endorphins in the blood most often faces fatigue, depression and sadness, melancholy, lack of strength and joy in life.

He behaves more aggressively, is conflict-prone and inattentive, has difficulty remembering and assimilating information and cannot concentrate on anything.

How to check your endorphin levels

To understand this issue, simply ask yourself a few questions:

1. Do you feel inner harmony?
2. Do you try to look for the good even in the worst situations?
3. Do you often dream about good things and stay positive?
4. Do you feel in the morning that the day is going to be good?
5. Are you able to avoid getting depressed during the “dark periods” in life?

Can you answer yes to at least half of the above questions? If yes, then your endorphin levels are fine. If not, let's figure out together how this can be fixed.

How to increase

There are many ways, and all of them will not cause you any harm. The first and most obvious thing after reading the article is playing sports.

As we remember, with prolonged physical activity, adrenaline begins to be produced, which increases muscle pain, as a result of which the level of endorphin, which reduces pain, also increases.

Ask any athlete about his state and mood after training - almost everyone will answer that this is a state of real pleasure.

Doing things you enjoy, like listening to music you like and watching good movies, will also increase your levels of this hormone. Of course, being sexually active and having sex will also help you become a little happier. Ultraviolet light can also help, so try going to the beach or solarium, or just walk more in sunny weather. Perhaps a slightly unexpected method, but acupuncture is also a very effective method, since during the procedure there is a sharp release of hormones, among which endorphin is present. Be sure to laugh and smile more often - a positive attitude will help you become happier.

Be sure to limit your intake of endorphin-stimulating foods (think alcohol and sweets) unless you consume them in moderation, as this will ultimately be bad for your hormone levels.

Improved mood and tone can also be caused by consuming the “right” foods:

• bananas - one fruit per day is enough to stimulate the production of several joy hormones at once;
• avocado - half the fruit and improvement is guaranteed;
• mustard - its consumption also leads to increased production of happiness hormones;
• paprika - improves brain activity, as a result of which hormones are produced more intensively;
• beets - contains folic acid, which breaks down homocysteine, which can lead to worsening mood;
• thyme is an excellent sedative. Just two spoons a day with honey will help you become a little more relaxed;
• red currant - improves the regeneration of body cells, thereby increasing tone;
• chili pepper - directly affects the production of endorphins due to the content of capsacin. It is not at all necessary to eat the hottest peppers; sweet ones are enough;
• Chocolate - Consuming a few small pieces in moderation can bring you a little joy in your life. It is best to choose dark chocolate.

Smells can also help. The aromas of vanilla and lavender can soothe, which will also be a noticeable bonus.

Pathological diseases are also possible in which the natural production of the hormone is disrupted. In this case, treatment is necessary, often involving drug stimulation of endorphin production.

Is elevated hormone levels dangerous?

Of course, excess is also not very good. With excessive production of endorphins, a person, as you might guess, falls into a state of excessive euphoria and pleasure and can easily lose control over the situation and his behavior. This can lead to not the most positive consequences, which a person may not even remember due to the fact that with excessive hormone synthesis, memory lapses are possible. In addition, a hysterical state and inappropriate behavior may be observed.

Excessive endorphin production is not as common in humans as underproduction. However, it is possible, and all that needs to be done in such situations is to try to calm down.

conclusions

Modern life forces us to adapt very seriously to external circumstances and constant changes, which certainly leads to problems, including health problems. To live a long and happy life, it is advisable to follow the recommendations given to you above and go through life with them. I wish you a joyful life filled with natural endorphins!

From time to time we all have to deal with loss of strength, stress, and fatigue. Some people find a way out of such conditions quite simply, while for others depression becomes an insurmountable problem, for which they have to consult a doctor. What accounts for this difference in response to stress?

It turns out that our body has a complex neuroregulation system that controls the functioning of all vital organs, and is also responsible for the efficiency of the functions of all body systems.

The main role in maintaining immunity and the general level of health, the formation of one or another scenario of behavior and even personal qualities of a person is played by endorphins- a group of chemical compounds similar to drugs that are produced by the pituitary gland.

Recently it has been proven that, depending on our emotions and feelings, they can be produced by other cells of our body. However, the level of production of these substances is purely individual and depends on both hereditary and genetic factors and the living conditions of the individual. This is why our response to adverse external conditions is so unique.

Endorphins became widely known in the mid-70s of the twentieth century. However, the effect of these substances was used back in Ancient China, when a system of acupuncture was developed to stimulate the defenses, overcome a number of functional disorders of the body, and for pain relief from injuries and diseases.

What do endorphins affect?

Later it was found that endorphins are divided into several groups, which differ in structure and composition, and have different effects on the body.

Spheres of their influence:

- general anesthetic effect;

- regulation of blood circulation and neurohumoral environment of the body under stress (dangerous situation);

- launching excitation-inhibition processes;

- creation of a number of associative-dissociative connections and activation of thinking;

- stimulation of metabolism;

- impact on the level of self-esteem;

- production of hormones responsible for the feeling of pleasure.

It turns out that the role of these mediators is difficult to overestimate. And the most interesting thing is that the endorphin production system can be trained. This was used by adherents of various Eastern teachings, developing in themselves truly miraculous properties that allowed them to survive in terrible conditions and overcome deadly situations.

Today, having knowledge about the structure and direction of action of these substances, it is possible to adjust the desired link in the endorphin system to obtain the desired effect.

How do endorphins work?

Responsible for stimulating the body in a deadly situation kappa receptors, causing insensitivity to pain due to the release of adrenaline, which allows you to concentrate all the body’s forces in an effort to survive.

Mu receptors contribute to a person’s recovery from stress: this is a feeling of euphoria that occurs after the danger has passed, a feeling of peace and tranquility, and the appearance of drowsiness. In our ordinary lives, the lack of this group of endorphins causes dissatisfaction with our life and provokes suicidal thoughts and actions.

Delta receptors are responsible for tissue regeneration processes, the level of immunity, influence self-esteem and metabolic rate in the body. The good functioning of these receptors generates a desire for leadership, sustainable mental health and human endurance. Underdevelopment of this group is associated with mood swings, poor health, indecision and increased sensitivity in stressful situations.

The creative potential of the individual, creativity and originality of thinking are ensured by the development sigma receptors, responsible for the intensity of neural connections, the quality of work and the interaction of various parts of the brain. This group of endorphins influences the processing and redistribution of information received from outside.

How can you train the endorphin system?

Stimulation of this most important group of mediators occurs:

2. When eating chocolate and hot red pepper, due to the production of substances necessary for their synthesis.

4. With proper organization of rest and work activity.

5. When listening to classical music.

Thus, everyone has the opportunity to choose the most suitable way to strengthen their body. Good health to you!

It is known that the effects of morphine-like analgesics on the human body are due to their interaction with opiate receptors. Currently, their endogenous ligands of peptide structure have been isolated. The most important of them are β-endorphin, leu- and met-enkephalins. It should be noted that the physiological role of endorphins and enkephalins is not fully understood. However, these peptides are believed to be involved in the regulation of extrapyramidal, limbic and neuroendocrine functions and, in addition, modulate pain perception, have euphoric and reinforcing properties. It is obvious that dependence on morphine-like drugs is largely due to changes in the functioning of the endogenous opioid system. At the same time, modern theories of withdrawal syndrome come down to various variants of homeostatic stress.

An increase in the content of β-endorphin in the blood plasma has been shown under various stress influences: surgical, anesthetic stress, hypoxia, fasting, electroconvulsive therapy. There is evidence of an increase in the level of β-endorphin in the cerebrospinal fluid during transcranial electroanalgesia, and the participation of β-endorphin in the effects of acupuncture. It has been shown that intravenous infusion of β-endorphin has the ability to alleviate withdrawal symptoms in patients with opium addiction.

Despite the importance of studying the endogenous opioid system in drug addicts, only a few studies have studied the level of opioid peptides in the biological fluids of patients with opiate addiction. Thus, the work showed that in patients with heroin addiction with moderate and severe withdrawal syndrome, the level of β-endorphin in the plasma and cerebrospinal fluid was higher, and the level of met-enkephalin in the cerebrospinal fluid was lower than in healthy subjects. A small number of such studies are associated with difficulties in determining β-endorphin, met- and leu-enkephalins in biofluids due to their rapid enzymatic degradation.

The purpose of this work is to study the dynamics of the content of β-endorphin, met- and leu-enkephalins in the blood plasma of patients with opiate addiction in the process of drug relief of opium withdrawal syndrome. 20 male patients aged 20–30 years with stage II opium addiction were examined. Experience in anesthesia - 4–6 years. All patients had a pronounced clinical picture of withdrawal syndrome (its average severity was 30.7±2.1 on the Gimmelsbach scale). All patients received the same type of detoxification therapy. In order to correct affective disorders, all patients were given intravenous drips of amitriptyline (40 mg per day). Blood was drawn in the morning on an empty stomach, before treatment. The first sample was taken at the height of the withdrawal syndrome, 72–80 after withdrawal from the drug, the second - on the 15–17th day of withdrawal from the drug. The control group consisted of healthy men 26–30 years old. Blood sampling was carried out under similar conditions (with the exception of therapeutic measures). Standard kits from Instar Corporation were used in this work.

According to our data, the average level of β-endorphin in the plasma of patients with opium addiction was higher, and leu- and met-enkephalins were lower than in the control group. In the process of relieving opium withdrawal syndrome, there was a further increase in the average level of β-endorphin and a decrease in leu- and met-enkephalin, while a wide range of β-endorphin concentrations in the blood plasma was observed in the process of relieving withdrawal syndrome from 9.1 to 18.6 pg/ ml. However, only the difference between the concentration of met-enkephalin in the plasma of healthy people and patients with opium addiction was significant. Differences in the content of opioid neuropeptides at the height of the withdrawal syndrome and after the acute period of abstinence were also unreliable. Summarized data are presented in table. 1.

Table 1

Note.

An analysis was carried out of the dependence of the content of opioid neuropeptides on the effectiveness of the therapeutic measures. The patients were divided into two groups depending on the severity of residual effects of withdrawal syndrome: 1st - patients with severe residual effects in the form of asthenodepressive syndrome, autonomic disorders, insomnia; 2nd - patients with mildly expressed asthenic syndrome. The content of neuropeptides in blood plasma, depending on the effectiveness of withdrawal syndrome relief, is presented in Table. 2.

table 2

Note. Significance of difference with control using Student's test: 1 - less than 0.95; 2 - more than 0.95.

The level of β-endorphin in plasma in patients of group 1 was significantly higher, and in group 2 even slightly lower, than in the control group. The concentrations of met- and leu-enkephalins did not differ significantly in the patient groups.

The data obtained indicate the involvement of the endogenous opioid system in the pathogenesis of opium addiction. The increase in β-endorphin content in plasma is probably adaptive in nature, as evidenced by its further increase during ineffective treatment and decrease in content after relief of withdrawal symptoms. Studying the dynamics of β-endorphin concentration can be used as a criterion for the effectiveness of treatment for patients with drug addiction.

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