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Recent developments in opiate research and their implications for psychiatry

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Summary

Considerable progress in opiate research has been made during the last few years regarding the identification and localization of opiate receptors in vitro and in vivo, the analysis of drug-receptor interactions and the characterization of an endogenous ligand of the opiate receptor. There is little evidence that effects induced by chronic exposure to opiates — development of tolerance and dependence — are due to changes in opiate receptor mechanisms; it is supposed that the adaptive changes occur mainly in the chain of events triggered by the drug-receptor interaction. Such changes may be directly or indirectly related to the metabolism of neurotransmitters and/or cyclic nucleotides. The obvious links between physical and psychic equivalents of opiate dependence are discussed. Present data points to the significance of brain stem and limbic structures in both these processes, monoamines probably playing an important role. Relations between psychic manifestations of opiate addiction and mental disorders are pointed out.

Zusammenfassung

Die Opiatforschung hat bei der Identifizierung und Lokalisierung der Opiatrezeptoren in vitro und in vivo, bei der Analyse der Opiat-Rezeptor-Wechselwirkung und bei der Charakterisierung eines endogenen Liganden des Opiatrezeptors in den letzten Jahren beträchtliche Fortschritte erzielt. Es gibt wenige Hinweise dafür, daß die Wirkungen chronischer Opiatzuführung — Entwicklung von Toleranz und Abhängigkeit — durch Veränderung von Opiatrezeptormechanismen bedingt sind; es ist eher anzunehmen, daß die durch die Wechselwirkung des Opiats mit dem Rezeptor ausgelösten Mechanismen sich adaptiv verändern. Direkte oder indirekte Veränderungen im Stoffwechsel von Neurotransmittern und/oder cyclischer Nukleotide spielen hierbei eine Rolle. Die zwischen körperlichen und psychischen Äquivalenten der Opiatabhängigkeit bestehenden Zusammenhänge werden diskutiert. Die vorliegenden Daten weisen darauf hin, daß in beiden Fällen der Hirnstamm und das limbische System bedeutsam sind und wahrscheinlich Monoaminen eine wesentliche Rolle zukommt. Beziehungen zwischen psychischen Erscheinungen der Opiatabhängigkeit und geistigen Störungen werden aufgezeigt.

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  1. Department of Neuropharmacology, Max-Planck-Institut für Psychiatrie, Kraepelinstr. 2, D-8000, München, Germany

    Albert Herz

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Herrn Professor Dr. med. Gerd Peters zu seinem 70. Geburtstag gewidmet.

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Herz, A. Recent developments in opiate research and their implications for psychiatry. Arch. F. Psychiatr. U. Z. Neur. 221, 183–197 (1976). https://doi.org/10.1007/BF00418479

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