Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder. A pilot study
R. K. Pitman, B. A. van der Kolk, S. P. Orr and M. S. Greenberg
Manchester Veterans Affairs Medical Center, NH.
We tested the hypothesis that exposure to a stimulus resembling the
original traumatic event would induce naloxone-reversible analgesia in
patients with posttraumatic stress disorder (PTSD). Eight medication-free
Vietnam veterans with PTSD and eight veterans without PTSD, matched for age
and combat severity, viewed a 15-minute videotape of dramatized combat
under naloxone hydrochloride and placebo conditions in a randomized
double-blind crossover design. In the placebo condition, the subjects with
PTSD showed a 30% decrease in reported pain intensity ratings of
standardized heat stimuli after the combat videotape. No decrease in pain
ratings occurred in the subjects with PTSD in the naloxone condition. The
subjects without PTSD did not show a decrease in pain ratings in either
condition. The results are consistent with the induction of opioid-mediated
stress-induced analgesia in the patients with PTSD.
Altered Pain Processing in Veterans With Posttraumatic Stress Disorder
Geuze et al.
Arch Gen Psychiatry 2007;64:76-85.
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Toward a Psychobiology of Posttraumatic Self-Dysregulation: Reexperiencing, Hyperarousal, Dissociation, and Emotional Numbing
FREWEN and LANIUS
Ann. N. Y. Acad. Sci. 2006;1071:110-124.
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Pain medication use among patients with posttraumatic stress disorder.
Schwartz et al.
Psychosomatics 2006;47:136-142.
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Brain Systems Underlying Susceptibility to Helplessness and Depression
Shumake and Gonzalez-Lima
Behav Cogn Neurosci Rev 2003;2:198-221.
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{micro}-Opioid receptors and limbic responses to aversive emotional stimuli
Liberzon et al.
Proc. Natl. Acad. Sci. USA 2002;99:7084-7089.
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Treating Traumatized Children: Clinical Implications of the Psychobiology of Posttraumatic Stress Disorder
COHEN et al.
Trauma Violence Abuse 2002;3:91-108.
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Pain and Emotion: Effects of Affective Picture Modulation
Meagher et al.
Psychosom. Med. 2001;63:79-90.
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