Naloxone-Reversible Analgesic Response to Combat-Related Stimuli in Posttraumatic Stress Disorder: A Pilot Study

doi:10.1001/archpsyc.1990.01810180041007

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Vol. 47 No. 6, June 1990

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Naloxone-Reversible Analgesic Response to Combat-Related Stimuli in Posttraumatic Stress Disorder

A Pilot Study

Roger K. Pitman, MD; Bessel A. van der Kolk, MD; Scott P. Orr, PhD; Mark S. Greenberg, PhD

Arch Gen Psychiatry. 1990;47(6):541-544.

Abstract

• We tested the hypothesis that exposure to a stimulusresembling the original traumatic event would induce naloxone-reversibleanalgesia in patients with posttraumatic stress disorder (PTSD).Eight medication-free Vietnam veterans with PTSD and eight veteranswithout PTSD, matched for age and combat severity, viewed a15-minute videotape of dramatized combat under naloxone hydrochlorideand placebo conditions in a randomized double-blind crossoverdesign. In the placebo condition, the subjects with PTSD showeda 30% decrease in reported pain intensity ratings of standardizedheat stimuli after the combat videotape. No decrease in painratings occurred in the subjects with PTSD in the naloxone condition.The subjects without PTSD did not show a decrease in pain ratingsin either condition. The results are consistent with the inductionof opioid-mediated stress-induced analgesia in the patientswith PTSD.

Author Affiliations

From the Manchester (NH) Veterans Affairs Medical Center (Drs Pitman and Orr), the Massachusetts Mental Health Center (Drs van der Kolk and Greenberg), and the Department of Psychiatry, Harvard Medical School, Boston, Mass (Drs Pitman, van der Kolk, Orr and Greenberg). Presented at the 141st Annual Meeting of the American Psychiatric Association, Montreal, Canada, May 9, 1988.

Footnotes

Accepted for publication October 13, 1989.

Reprint requests to Veterans Affairs Research Service, 228 MapleSt, Manchester, NH 03103 (Dr Pitman).

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