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.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Altered Pain Processing in Veterans With Posttraumatic Stress Disorder
Geuze et al.
Arch Gen Psychiatry 2007;64:76-85.
ABSTRACT | FULL TEXT  

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.
ABSTRACT | FULL TEXT  

Pain medication use among patients with posttraumatic stress disorder.
Schwartz et al.
Psychosomatics 2006;47:136-142.
ABSTRACT | FULL TEXT  

Brain Systems Underlying Susceptibility to Helplessness and Depression
Shumake and Gonzalez-Lima
Behav Cogn Neurosci Rev 2003;2:198-221.
ABSTRACT  

{micro}-Opioid receptors and limbic responses to aversive emotional stimuli
Liberzon et al.
Proc. Natl. Acad. Sci. USA 2002;99:7084-7089.
ABSTRACT | FULL TEXT  

Treating Traumatized Children: Clinical Implications of the Psychobiology of Posttraumatic Stress Disorder
COHEN et al.
Trauma Violence Abuse 2002;3:91-108.
ABSTRACT  

Pain and Emotion: Effects of Affective Picture Modulation
Meagher et al.
Psychosom. Med. 2001;63:79-90.
ABSTRACT | FULL TEXT