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Short-term Naloxone Administration in Schizophrenic and Manic PatientsA World Health Organization Collaborative Study
David Pickar, MD;
Felix Vartanian, MD;
William E. Bunney, Jr, MD;
Hans P. Maier, MD;
Markus T. Gastpar, MD;
Rudra Prakash, MD;
B. B. Sethi, MD;
Robert Lideman, MD;
Boris S. Belyaev, MD;
Mella V. A. Tsutsulkovskaja, MD;
Gerd Jungkunz, MD;
Norbert Nedopil, MD;
Willem Verhoeven, MD;
Herman van Praag, MD
Arch Gen Psychiatry. 1982;39(3):313-319.
Abstract
• A double-blind study of the behavioral effects of short-term naloxone hydrochloride administration was performed in 32 schizophrenic and 26 manic patients in a World Health Organization collaborative project. There was a significant naloxoneassociated reduction in overall physician-rated symptoms in schizophrenic patients concurrently treated with neuroleptic medication (N = 19) but not in medication-free schizophrenics (N = 13). Physician ratings of auditory hallucinations showed significant naloxone-associated improvement for the total schizophrenic population, while self-ratings of auditory hallucinations showed improvement only in neuroleptic-treated schizophrenics. While further studies are needed to delineate these effects as to clinical significance, they may bear etiological implications for the psychobiology of schizophrenia, including the possibility of synergistic effects of dopamine and endorphin blockade. Naloxone produced no significant behavioral effects in manic patients. These findings are discussed with relationship to the hypotheses of endorphin involvement in schizophrenia and mania.
Author Affiliations
From the Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Md (Drs Pickar and Bunney); Division of Mental Health, World Health Organization, Geneva (Dr Vartanian); Psychiatrische Universitätsklinik, Basel, Switzerland (Drs Maier and Gastpar); Department of Psychiatry, King George's Medical College, Lucknow, India (Drs Prakash and Sethi); Institute of Psychiatry, Academy of Medical Sciences, Moscow (Drs Lideman, Belyaev, and Tsutsulkovskaja); Psychiatrische Klinik und Poliklinik der Universität München, Munich, West German Federal Republic (Drs Jungkunz and Nedopil); and the Department of Psychiatry, University Hospital, Utrecht, the Netherlands (Drs Verhoeven and van Praag).
Footnotes
Accepted for publication June 18, 1981.
Reprint requests to Biological Psychiatry Branch, National Institute of Mental Health, Bldg 10, Room 2N210, Bethesda, MD 20205 (Dr Pickar).
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