Abstract
An unusual behavioral and cardiovascular reaction was observed during opioid blockade with naltrexone in a 32-year-old male who met DSM III-R criteria for post-traumatic stress disorder (PTSD). As part of an ongoing placebo-controlled investigation of the effects of naltrexone on laboratory and ambulatory blood pressure reactivity, this participant reported experiencing feelings of rage, explosive behavior, and other unpleasant symptoms. When compared to all other subjects (N=24), this individual showed significantly greater effects of naltrexone on blood pressure reactivity during the laboratory stressor. His ambulatory blood pressures, when compared to placebo, were significantly increased during the 24-hr period following naltrexone. The unusual behavioral and cardiovascular responses following ingestion of naltrexone suggest an important role for endogenous opioids in adjustment to stress in this case of PTSD.
References
American Psychiatric Association (1987).Diagnostic and Statistical Manual of Mental Disorders (Third Edition-Revised), Washington, DC: Author.
Bandura, A., Cioffi, Taylor, C. B., and Brouillard, M. E. (1988). Perceived self-efficacy in coping with cognitive stressors and opioid activation.J. Personal. Social Psychol. 55: 479–488.
Gold, M. S., Redmond, D. G., and Kleber, H. D. (1978). Clonidine blocks acute opiate withdrawal symptoms.Lancet 2: 599–601.
Kolb, L. C., Burris, B. C., and Griffiths, S. (1984). Propranolol and clonidine in the treatment of post traumatic stress disorders of war. In Van der Kolk, B. A. (ed.),Post-traumatic Stress Disorder: Psychological and Biological Sequelae, American Psychiatric Press, Washington, DC, pp. 98–105.
McCubbin, J. A. (1993). Stress and endogenous opioids: Behavioral and circulatory interactions.Biol. Psychol. 35: 91–122.
McCubbin, J. A., Cheung, R., Montgomery, T. B., Bulbulian, R., Wilson, J. F. (1992). Aerobic fitness and opiodergic inhibition of cardiovascular stress reactivity.Psychophysiology 29: 687–697.
McCubbin, J. A., Kizer, J. S., and Lipton, M. A. (1984). Naltrexone prevents footshock-induced performance deficits in rats.Life Sci. 34: 2057–2066.
McCubbin, J. A., Surwit, R. S., and Williams, R. B. (1985). Endogenous opiate peptides, stress reactivity, and risk for hypertension.Hypertension 7: 808–811.
McCubbin, J. A., Surwit, R. S., Williams, R. B., Nemeroff, C. B., and McNeilly, M. (1989). Altered pituitary hormone response to naloxone in hypertension development.Hypertension 14: 636–644.
Pitman, R. K., van der Kolk, B. A., Orr, S. P., and Greenberg, M. S. (1990). Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder.Arch. Gen. Psychiat. 47: 541–544.
Van der Kolk, B., Greenberg, M., Boyd, H., and Krystal, J. (1985). Inescapable shock, neurotransmitters, and addiction to trauma: Towards a psychobiology of post-traumatic stress.Biol Psychiatr. 20: 314–325.
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Ibarra, P., Bruehl, S.P., McCubbin, J.A. et al. An unusual reaction to opioid blockade with naltrexone in a case of post-traumatic stress disorder. J Trauma Stress 7, 303–309 (1994). https://doi.org/10.1007/BF02102950
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DOI: https://doi.org/10.1007/BF02102950