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2Adrenergic and Opiate Receptor Blockade

Synergistic Effects on Anxiety in Healthy Subjects

Dennis S. Charney, MD; George R. Heninger, MD

Arch Gen Psychiatry. 1986;43(11):1037-1041.

Abstract
• To evaluate interactions between the opiate and adrenergic systems in healthy humans, concomitant administration of the opiate antagonist, naloxone hydrochloride, and the 2-adrenergic receptor antagonist, yohimbine hydrochloride, was compared with the administration of placebo and of each drug separately. A synergistic effect of the combination (larger than the sum of the effects of the two drugs separately) was observed on subject ratings of nervousness, anxiety, tremors, palpitations, nausea, hot and cold flashes, and increased plasma cortisol concentrations. In addition, following the combination, each of the male subjects studied reported a full penile erection lasting at least 60 minutes, an effect not reported when each drug was given separately. These results demonstrate that interactions between the opiate the adrenergic systems have important implications for our understanding of the cause and treatment of anxiety disorders and male impotence.

Author Affiliations
From the Clinical Neuroscience Research Unit, Ribicoff Research Facilities, Connecticut Mental Health Center, and the Department of Psychiatry, Yale University School of Medicine, New Haven.

Footnotes
Accepted for publication Dec 6, 1985.

Reprint requests to Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park St, New Haven, CT 06508 (Dr Charney).

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