Guanfacine alters the effect of stress and smoking on heart rate variability in regular daily smokers

• Published in: Psychopharmacology 2017-03, Vol.234 (5), p.805-813
• Main Authors: Verplaetse, Terril L., Smith, Philip H., Smith, Kathryn M. Z., Oberleitner, Lindsay M., McKee, Sherry A.
• Format: Article
• Language: English
• Subjects: Adrenergic alpha-2 Receptor Agonists - pharmacology; Adult; Biomedical and Life Sciences; Biomedicine; Cognitive enhancement; Dosage and administration; Female; Guanfacine; Guanfacine - pharmacology; Health aspects; Heart rate; Heart Rate - drug effects; Heart Rate - physiology; Humans; Male; Middle Aged; Neurosciences; Original Investigation; Pharmacology/Toxicology; Prescription drugs; Psychiatry; Psychological aspects; Smokers; Smoking; Stress; Stress, Psychological - physiopathology; Tobacco Smoking - physiopathology; Vagus Nerve; Young Adult
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-016-4517-1

Background We had previously demonstrated that guanfacine, an α2a-adrenergic agonist, attenuated the effect of stress on smoking-lapse behavior in regular daily smokers. Heart rate variability (HRV), a measure of vagal activity, may be a potential mechanism underlying the relationship between stress, smoking, and relapse. Methods We examined whether guanfacine (0 mg/day vs. 3 mg/day; n  = 26) altered changes in high-frequency heart rate variability (HF-HRV) following stress and ad-lib smoking using a validated laboratory analogue of smoking-lapse behavior. All participants completed a parent study evaluating the effects of guanfacine on stress-precipitated smoking. Each subject completed two laboratory sessions assessing the effects of guanfacine on HF-HRV following stress imagery (vs. neutral imagery; order counterbalanced) and smoking. Results Results demonstrated that guanfacine did not increase tonic levels of HF-HRV relative to placebo. Following the stress versus neutral imagery manipulation (prior to ad-lib smoking), there were no significant changes in HF-HRV in the placebo group. In contrast, guanfacine increased phasic HF-HRV following stress imagery and decreased HF-HRV following neutral imagery. Ad libitum smoking following both the stress and neutral conditions decreased HF-HRV in the placebo group across both imagery conditions. In contrast, guanfacine attenuated stress- and smoking-related decreases in phasic HF-HRV relative to the neutral imagery condition. Conclusions This is the first demonstration that a noradrenergic target altered dynamic changes in HF-HRV in response to stress and smoking, suggesting that guanfacine alters HF-HRV response to stress. Findings support current theories which suggest that phasic changes in HRV are an important marker of the stress response.