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El Hayek SA, Shatila MA, Adnan JA, Geagea LE, Kobeissy F, Talih FR. Is there a therapeutic potential in combining bupropion and naltrexone in schizophrenia? Expert Rev Neurother 2022; 22:737-749. [PMID: 36093756 DOI: 10.1080/14737175.2022.2124369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION A sustained-release tablet composed of a combination of the dopamine and norepinephrine reuptake inhibitor bupropion (BUP) and the µ-opioid receptor antagonist naltrexone (NAT) is marketed under the brand name Contrave by Orexigen Therapeutics for appetite control. Minimal literature is available regarding the use of combination bupropion and naltrexone (BUPNAT) in individuals with schizophrenia. AREAS COVERED In this review, we propose a theoretical model where BUPNAT may have a therapeutic effect in the treatment of schizophrenia. We explore the pathways targeted by the constituent drugs BUP and NAT and summarize the literature on their efficacy and possible adverse effects. We then look at the potential use of BUPNAT in schizophrenia. EXPERT OPINION Research has hinted that BUP's dopaminergic properties affect the same striatal pathways involved in schizophrenia. NAT, via opioid receptor antagonism, indirectly increases striatal dopamine release by disinhibiting nicotinic acetylcholine receptors. As such, we hypothesize that BUPNAT can have a therapeutic effect in schizophrenia, particularly on negative symptoms. We also suggest that it may ameliorate comorbidities frequently seen in this group of patients, including obesity, smoking, and substance use. Further research and clinical data are needed to elucidate the potential clinical benefits of BUPNAT in the treatment of schizophrenia.
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Affiliation(s)
- Samer A. El Hayek
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Malek A. Shatila
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jana A. Adnan
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Luna E. Geagea
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Farid R. Talih
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
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Clark SD, Van Snellenberg JX, Lawson JM, Abi-Dargham A. Opioid antagonists are associated with a reduction in the symptoms of schizophrenia: a meta-analysis of controlled trials. Neuropsychopharmacology 2020; 45:1860-1869. [PMID: 32516800 PMCID: PMC7608351 DOI: 10.1038/s41386-020-0730-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/10/2020] [Accepted: 06/01/2020] [Indexed: 11/23/2022]
Abstract
Current treatments for the symptoms of schizophrenia are only effective for positive symptoms in some individuals, and have considerable side effects that impact compliance. Thus, there is a need to investigate the efficacy of other compounds in treating both positive and negative symptoms. We conducted a meta-analysis of English language placebo-controlled clinical trials of naloxone, naltrexone, nalmefene, and buprenorphine in patients with schizophrenia to determine whether opioid antagonists have therapeutic efficacy on positive, negative, total, or general symptoms. We searched online databases Ovid Medline and PsychINFO, PubMed, EMBASE, Scopus, Cochrane library/CENTRAL, Web of Science, and Google Scholar from 1970 through February 2019. Following PRISMA guidelines, Hedges g was calculated for each study. Primary study outcomes were the within-subject change on any symptom assessment scale for positive, negative, total, or general symptoms of schizophrenia between active drug and placebo conditions. Thirty studies were included with 434 total patients. We found a significant effect of all drugs on all scales combined with both a standard random effects model: (g = 0.26; P = 0.02; k = 22; CI = 0.03-0.49) and a more inclusive bootstrap model: (g = 0.26; P = 0.0002; k = 30; CI = 0.11-0.51) and a significant effect on total scales with the bootstrap model (g = 0.25288; P = 0.015; k = 19; CI = 0.04-0.35). We also observed a significant effect of all drugs on all positive scales combined with both the random effects (g = 0.33; P = 0.015; k = 17; CI = 0.07-0.60) and bootstrap models (g = 0.32; P < 0.0001; k = 21; CI = 0.13-1.38). This evidence provides support for further testing in randomized clinical trials of a new class of non-D2-receptor drugs, based on opioid mechanisms, for the treatment of positive and negative symptoms of schizophrenia.
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Affiliation(s)
- Samuel D Clark
- Columbia University Medical Center, New York, NY, USA.
- Terran Biosciences, New York, NY, USA.
| | - Jared X Van Snellenberg
- Department of Psychiatry and Behavioral Health, Stony Brook University Medical Center, New York, NY, USA
- Department of Psychology, Stony Brook University, New York, NY, USA
- Department of Biomedical Engineering, Stony Brook University, New York, NY, USA
| | | | - Anissa Abi-Dargham
- Department of Psychiatry and Behavioral Health, Stony Brook University Medical Center, New York, NY, USA
- Department of Biomedical Engineering, Stony Brook University, New York, NY, USA
- Department of Radiology, Stony Brook University Medical Center, New York, NY, USA
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Clark SD, Abi-Dargham A. The Role of Dynorphin and the Kappa Opioid Receptor in the Symptomatology of Schizophrenia: A Review of the Evidence. Biol Psychiatry 2019; 86:502-511. [PMID: 31376930 DOI: 10.1016/j.biopsych.2019.05.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/25/2019] [Accepted: 05/05/2019] [Indexed: 01/17/2023]
Abstract
Schizophrenia is a debilitating mental illness that affects approximately 1% of the world's population. Despite much research in its neurobiology to aid in developing new treatments, little progress has been made. One system that has not received adequate attention is the kappa opioid system and its potential role in the emergence of symptoms, as well as its therapeutic potential. Here we present an overview of the kappa system and review various lines of evidence derived from clinical studies for dynorphin and kappa opioid receptor involvement in the pathology of both the positive and negative symptoms of schizophrenia. This overview includes evidence for the psychotomimetic effects of kappa opioid receptor agonists in healthy volunteers and their reversal by the pan-opioid antagonists naloxone and naltrexone and evidence for a therapeutic benefit in schizophrenia for 4 pan-opioid antagonists. We describe the interactions between kappa opioid receptors and the dopaminergic pathways that are disrupted in schizophrenia and the histologic evidence suggesting abnormal kappa opioid receptor signaling in schizophrenia. We conclude by discussing future directions.
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Affiliation(s)
- Samuel David Clark
- Columbia University Medical Center, New York; Terran Biosciences Inc., New York.
| | - Anissa Abi-Dargham
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
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Lee DB, Woo YS, Bahk WM. Naltrexone-associated Visual Hallucinations: A Case Report. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2019; 17:329-331. [PMID: 30905136 PMCID: PMC6478085 DOI: 10.9758/cpn.2019.17.2.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 12/26/2017] [Accepted: 12/27/2017] [Indexed: 11/30/2022]
Abstract
Naltrexone is a competitive antagonist of μ, δ, and κ opioid receptors. Naltrexone has been investigated for use an as anti-obesity agent in both the general population and in patients with severe mental illness, including schizophrenia. In patients with schizophrenia, however, potential psychotic symptoms due to adverse effects of naltrexone have not been investigated. Our case study, a relevant case report, and some related articles suggest that naltrexone might be associated with the emergence of visual hallucinations, which clinicians should be aware of.
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Affiliation(s)
- Dae Bo Lee
- Department of Psychiatry, National Forensic Hospital
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea
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Sutter M, Walter M, Dürsteler KM, Strasser J, Vogel M. Psychosis After Switch in Opioid Maintenance Agonist and Risperidone-Induced Pisa Syndrome: Two Critical Incidents in Dual Diagnosis Treatment. J Dual Diagn 2017; 13:157-165. [PMID: 27935442 DOI: 10.1080/15504263.2016.1269224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case that illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature. CASE DESCRIPTION We report on a 56-year-old patient with schizophrenia and opioid dependence who experienced both risperidone-induced Pisa syndrome and, 3 years later, acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT prolongation. CONCLUSIONS With the current availability of a diversity of substitution opioids in Switzerland (methadone, buprenorphine, diacetylmorphine, sustained-release oral morphine), studies on differential effectiveness of these agents in opioid-dependent subpopulations with selective comorbidity profiles are desirable. The same is true for further investigation of the involvement of the opioid receptor system in schizophrenia. In clinical practice, any alteration of opioid medication in patients with dual diagnosis and a history of schizophrenia should be accompanied by close observation for psychotic symptoms.
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Affiliation(s)
- Manuel Sutter
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Marc Walter
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Kenneth M Dürsteler
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Johannes Strasser
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Marc Vogel
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
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Cáceda R, Kinkead B, Nemeroff CB. Involvement of neuropeptide systems in schizophrenia: human studies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2007; 78:327-76. [PMID: 17349866 DOI: 10.1016/s0074-7742(06)78011-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Neuropeptides are heterogeneously distributed throughout the digestive, circulatory, and nervous systems and serve as neurotransmitters, neuromodulators, and hormones. Neuropeptides are phylogenetically conserved and have been demonstrated to regulate numerous behaviors. They have been hypothesized to be pathologically involved in several psychiatric disorders, including schizophrenia. On the basis of preclinical data, numerous studies have sought to examine the role of neuropeptide systems in schizophrenia. This chapter reviews the clinical data, linking alterations in neuropeptide systems to the etiology, pathophysiology, and treatment of schizophrenia. Data for the following neuropeptide systems are included: arginine-vasopressin, cholecystokinin (CCK), corticotropin-releasing factor (CRF), interleukins, neuregulin 1 (NRG1), neurotensin (NT), neuropeptide Y (NPY), opioids, secretin, somatostatin, tachykinins, thyrotropin-releasing hormone (TRH), and vasoactive intestinal peptide (VIP). Data from cerebrospinal fluid (CSF), postmortem and genetic studies, as well as clinical trials are described. Despite the inherent difficulties associated with human studies (including small sample size, variable duration of illness, medication status, the presence of comorbid psychiatric disorders, and diagnostic heterogeneity), several findings are noteworthy. Postmortem studies support disease-related alterations in several neuropeptide systems in the frontal and temporal cortices. The strongest genetic evidence supporting a role for neuropeptides in schizophrenia are those studies linking polymorphisms in NRG1 and the CCKA receptor with schizophrenia. Finally, the only compounds that act directly on neuropeptide systems that have demonstrated therapeutic efficacy in schizophrenia are neurokinin receptor antagonists. Clearly, additional investigation into the role of neuropeptide systems in the etiology, pathophysiology, and treatment of schizophrenia is warranted.
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Affiliation(s)
- Ricardo Cáceda
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, Georgia 30322, USA
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Sernyak MJ, Glazer WM, Heninger GR, Charney DS, Woods SW, Petrakis IL, Krystal JH, Price LH. Naltrexone augmentation of neuroleptics in schizophrenia. J Clin Psychopharmacol 1998; 18:248-51. [PMID: 9617985 DOI: 10.1097/00004714-199806000-00011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study was conducted to determine whether the addition of naltrexone to ongoing neuroleptic treatment would facilitate the reduction in positive or negative symptoms in patients with schizophrenia. Twenty-one patients meeting DSM-III criteria for schizophrenia were enrolled; all patients had been stabilized for at least 2 weeks on their dosage of neuroleptic medicine before entering the study. Patients were randomized to receive either placebo or naltrexone 200 mg/day for 3 weeks in addition to their neuroleptic. Patients randomized initially into the placebo arm were crossed over to receive naltrexone in a single-blind fashion for 3 additional weeks. All patients were rated weekly with the Brief Psychiatric Rating Scale (BPRS). Fifteen patients received placebo and six received naltrexone in the first 3 weeks. No significant effects of naltrexone on total BPRS scores or BPRS subscale scores were observed. Patients who received naltrexone on a single-blind basis at the end of the placebo-controlled trial demonstrated a transient exacerbation in negative symptoms as reflected by the total BPRS score and the BPRS Withdrawal-Retardation subscale score. Repeated-measures analysis of variance (ANOVA) on the BPRS total score of the subsequent treatment with naltrexone showed a trend for a significance in the drug by time effect. Repeated-measures ANOVA on the BPRS Withdrawal-Retardation subscale of the subsequent treatment with naltrexone showed a significant drug by time effect. The current data failed to indicate a clinical benefit when naltrexone was added to the neuroleptic regimen. Other potential applications of naltrexone in schizophrenia are addressed.
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Affiliation(s)
- M J Sernyak
- Neuropsychiatry Program, VA Connecticut Health Care System, West Haven Campus 06516, USA
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8
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Pechter BM, Miller NS. Psychopharmacotherapy for addictive and comorbid disorders: current studies. J Addict Dis 1997; 16:23-40. [PMID: 9328807 DOI: 10.1080/10550889709511141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Proper diagnosis of comorbid disorders is crucial in treatment planning for the dually diagnosed. Since psychoactive substance use can obfuscate the diagnosis, special care must be taken to exclude organically based syndromes. Adequate periods of abstinence should first be achieved and subsequently the patient re-examined for residual symptoms compatible with a nonaddictive, nonsubstance-induced psychiatric disorder. The integration of concurrent treatment of both the mental and the addictive disorders appears to be the best approach for treatment of comorbid psychiatric and addictive disorders. An abstinence-based model that typically utilizes a 12-step group therapy is often employed for the addictive illnesses. Other forms of psychosocial therapies such as case managers are being used as well. Presently, physicians' prescribing practices for comorbid addicted patients are based on traditional approaches to use of medications in psychiatric patients, and their attitudes towards addictive disorders may play a significant role in determining the overall success of treatment.
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Affiliation(s)
- B M Pechter
- University of Illinois at Chicago 60612-7327, USA
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Marchesi GF, Santone G, Cotani P, Giordano A, Chelli F. The therapeutic role of naltrexone in negative symptom schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 1995; 19:1239-49. [PMID: 8868206 DOI: 10.1016/0278-5846(95)00263-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
1. Naltrexone (50 mg bid, p.o.) was administered in a double-blind fashion (with placebo control) to chronic schizophrenic patients who maintained their routine neuroleptic and anxiolytic therapy. 2. Both positive and negative symptom patients who received naltrexone improved with regard to symptoms involving deterioration and social withdrawal. No significant amelioration was recorded in subjects assuming placebo relative to the same psychopathological areas. 3. Favourable results were obtained mainly from patients affected by negative symptom schizophrenia. 4. Naltrexone may have acted by direct or indirect neurochemical mechanisms related to negative symptom schizophrenia.
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Affiliation(s)
- G F Marchesi
- Institute of Psychiatry, University of Ancona, Italy
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Abstract
Numerous studies suggest that opiate antagonists may have antipsychotic properties. A review of the literature describing the use of naloxone to treat schizophrenic patients has shown mixed results. The three studies on naltrexone have found no benefit in controlling auditory hallucinations. We present a synopsis of these studies.
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Affiliation(s)
- E B Welch
- Department of Pharmacy Practice, School of Pharmacy, Southwestern Oklahoma State University, Weatherford 73096
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11
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Gonzalez JP, Brogden RN. Naltrexone. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of opioid dependence. Drugs 1988; 35:192-213. [PMID: 2836152 DOI: 10.2165/00003495-198835030-00002] [Citation(s) in RCA: 195] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Naltrexone is a long acting competitive antagonist at opioid receptors which blocks the subjective and objective responses produced by intravenous opioid challenge. It is suitable for oral administration, and has been studied as an adjunct for use in opioid addiction management programmes. In non-comparative clinical trials involving detoxified patients, oral naltrexone reduced heroin craving and between 23 and 62% of patients remained in treatment after 3 to 4 weeks. However, in two studies 32 to 58% of patients who continued in treatment were opioid-free between 6 and 12 months after stopping naltrexone. As might be expected studies involving highly motivated patients have shown this type of patient group to achieve greater treatment success rates during naltrexone therapy, and remain opioid-free longer than other groups of apparently less motivated patients. In addition, when naltrexone is combined with family support, psychotherapy and counselling, patients are more likely to remain opioid-free. Naltrexone produces a low incidence of side effects, with gastrointestinal effects being the most commonly reported symptoms. Thus, despite the overall high attrition rates from trials, in selected patient groups and in combination with appropriate support mechanisms and psychotherapy, naltrexone represents a useful adjunct for the maintenance of abstinence in the detoxified opioid addict.
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Wolkowitz OM, Doran AR, Breier A, Cohen MR, Pickar D. Endogenous opioid regulation of hypothalamo-pituitary-adrenal axis activity in schizophrenia. Biol Psychiatry 1986; 21:366-73. [PMID: 2869791 DOI: 10.1016/0006-3223(86)90164-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We utilized a naloxone challenge strategy to investigate the functioning of the endogenous opioid system (EOS) in schizophrenia. Patients with schizophrenia, who were on neuroleptic medication or drug-free, demonstrated a significantly larger serum cortisol response to opioid blockade by naloxone than did age- and sex-matched normal controls. Patients, but not normal controls, also demonstrated an inverse relationship between baseline cortisol and the magnitude of the response. This enhanced cortisol response is consistent with tonic hyperactivity of the EOS in schizophrenia.
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14
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Malick JB, Herman RL, Goldstein JM. A comparison of naloxone and naltrexone in laboratory tests predictive of antipsychotic potential. Drug Dev Res 1983. [DOI: 10.1002/ddr.430030307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Gitlin MJ, Gerner RH, Rosenblatt M. Assessment of naltrexone in the treatment of schizophrenia. Psychopharmacology (Berl) 1981; 74:51-3. [PMID: 6791204 DOI: 10.1007/bf00431756] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Naltrexone, a long acting opiate antagonist, and placebo were administered to eight schizophrenics in doses of 200 mg per day for 1 week in a double-blind, crossover design. No improvement was noted, and no side effects resembling the opiate withdrawal syndrome with naltrexone were found. Naltrexone does not appear to alter schizophrenic symptomatology.
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Endorphins and schizophrenia—Narcotic antagonists in the treatment of chronic schizophrenia. ACTA ACUST UNITED AC 1980. [DOI: 10.1016/0306-3623(80)90051-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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van Praag HM, Verhoeven WM. Neuropeptides. A new dimension in biological psychiatry. PROGRESS IN BRAIN RESEARCH 1980; 53:229-52. [PMID: 7005944 DOI: 10.1016/s0079-6123(08)60067-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Beddell CR, Lowe LA, Wilkinson S. Endogenous opioid peptides--the enkephalins and endorphins. PROGRESS IN MEDICINAL CHEMISTRY 1980; 17:1-39. [PMID: 6273969 DOI: 10.1016/s0079-6468(08)70156-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Lal S, Nair NP, Cervantes P, Pulman J, Guyda H. Effect of naloxone or levallorphan on serum prolactin concentrations and apomorphine-induced growth hormone secretion. Acta Psychiatr Scand 1979; 59:173-9. [PMID: 420037 DOI: 10.1111/j.1600-0447.1979.tb06959.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Naloxone HCl (0.8 mg intravenously; n=9) or levallorphan tartrate (0.25 mg subcutaneously; n=5) had no effect on basal prolactin or growth hormone secretion in normal men. Neither narcotic antagonist inhibited the growth hormone secretory response to apomorphine HCl (0.75 mg subcutaneously). These findings suggest that narcotic antagonists do not block dopamine receptors in the hypothalamic-pituitary axis in man and that if these agents have antischizophrenic properties then these are not mediated by dopamine receptor blockade.
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