Naloxone administration in chronic hallucinating schizophrenic patients

  • Philip A. Berger
  • Stanley J. Watson
  • Huda Akil
  • Jack D. Barchas

Abstract

The recent discovery of the endogenous opiate peptides has been followed by a massive research effort aimed at defining the role of these substances in both normal and abnormal physiology. A part of this research has focused on the possible role of the opiate peptides in psychiatric disorders. Controversial evidence has recently been presented suggesting a role for endogenous opiate systems in mood and psychoses. Terenius et al. (1976) reported that some opiate peptide fractions were elevated in unmedicated schizophrenic and manic patients. These concentrations decreased when the schizophrenic patients were medicated and when the manic patients became depressed (Terenius et al. 1976). Gunne et al. (1977) then attempted to reverse the theorized opiate peptide contribution to schizophrenia by administering the opiate antagonist naloxone (0.4 mg, i.v.). They reported decreased auditory hallucinations in four of six schizophrenic patients tested. This study was single blind, did not use standard rating scales or explicit subject selection criteria (Gunne et al. 1977). Yet, the report of decrease or loss of auditory hallucinations was intriguing. Several groups then attemptedto replicate this study without much success. Volavka et al. (1977) used the same dose of naloxone (0.4 mg) in carefully selected subjects, observed them for several hours and observed no effect on schizophrenic symptoms. Davis et al. (1977) gave between 0.4 and 10 mg of naloxone i.v. (usually, 0.4 mg) to patients from several diagnostic categories. These patients were studied for 1 hour and while they may have had improved cognition, no change in hallucinations was reported. Most recently Janowsky et al. (1977) have infused 1.2 mg of naloxone to a general population of schizophrenic subjects and observed no important changes over an hour.

Keywords

Placebo Dopamine Schizophrenia Respiration Morphine 

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Copyright information

© The contributors 1979

Authors and Affiliations

  • Philip A. Berger
    • 1
  • Stanley J. Watson
    • 1
  • Huda Akil
    • 1
  • Jack D. Barchas
    • 1
  1. 1.Psychiatric Clinical Research Center and Nancy Pritzker Laboratory of Behavioral Neurochemistry, Department of Psychiatry and Behavioral Sciences, Stanford University School of MedicineStanfordUSA

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