Negative naloxone effects in schizophrenic patients

Janowsky, David S.; Segal, David S.; Abrams, Alan; Bloom, Floyd E.; Guillemin, Roger

doi:10.1007/bf00492367

Cited by 34 publications

(6 citation statements)

References 4 publications

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“…Our immunohistochemical studies have shown that (5-endorphin is located in the intermediate and anterior lobes of the pituitary ), in the same cells known to secrete ACTH. This suggestion was supported by reports in which naloxone, a morphine and endorphin antagonist, was found to reduce auditory hallucinations in some schizophrenic patients (Gunne et al 1977), but not in all (Janowsky et al 1977). 31.000), secreted by pitu¬ itary cells (Mains et al 1977) and that ACTH and ß-endorphin are re¬ leased concomitantly in response to stress, adrenalectomy or steroid treatment .…”

Section: Introductory Remarksmentioning

confidence: 75%

Neuroendocrine Symposium of the Signe and Ane Gyllenberg Foundation

Gordin¹,

Lamberg²

1978

Acta Endocrinologica

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Signe and Ane Gyllenberg Foundation was established inHelsinki in 1949. It consists of two sections, one for art and the other for medicine. The art collection is located in Villa Gyllenberg in Helsinki which became a museum after the death of the donators in 1977.The medical section of the Foundation supports research dealing with the influence of the mind on the somatic functions and state of health of the body and with the mechanism involved in the interaction between these entities. According to current terminology, this vast field of research falls under the general heading Psychosomatic Medicine. The Foundation has also sponsored conferences and symposia in this field both on national and international levels. In 1978, 64 grants were awarded from the medical section of the Foundation.The last symposium sponsored by the Foundation was held in Matinkyl\l=a"\outside Helsinki in 1976. Results of 31 research projects were presented and discussed by over 100 participants.The present symposium deals with psychoneuroendocrinology representing basic science within the field of psycho¬ somatic medicine. The importance of this topic is shown by the fact that the last Nobel prize in medicine was awarded for research in neuroendocrinology.

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Section: Introductory Remarksmentioning

confidence: 75%

Neuroendocrine Symposium of the Signe and Ane Gyllenberg Foundation

Gordin¹,

Lamberg²

1978

Acta Endocrinologica

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“…This resulted in 27 publications detailing 30 blinded placebo-controlled trials for our final analysis comprising 434 total patients. Of these 30 trials, one utilized nalmefene [ 87 ] and one utilized buprenorphine [ 88 ], resulting in 28 trials that utilized naloxone or naltrexone [ 8 , 22 , 64 – 67 , 70 – 72 , 84 , 86 , 89 – 102 ]. The characteristics of included participants are reported in Supplementary Table S6 .…”

Section: Resultsmentioning

confidence: 99%

Opioid antagonists are associated with a reduction in the symptoms of schizophrenia: a meta-analysis of controlled trials

Clark

Snellenberg

Lawson

et al. 2020

Neuropsychopharmacol.

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Current treatments for the symptoms of schizophrenia are only effective for positive symptoms in some individuals, and have considerable side effects that impact compliance. Thus, there is a need to investigate the efficacy of other compounds in treating both positive and negative symptoms. We conducted a meta-analysis of English language placebo-controlled clinical trials of naloxone, naltrexone, nalmefene, and buprenorphine in patients with schizophrenia to determine whether opioid antagonists have therapeutic efficacy on positive, negative, total, or general symptoms. We searched online databases Ovid Medline and PsychINFO, PubMed, EMBASE, Scopus, Cochrane library/CENTRAL, Web of Science, and Google Scholar from 1970 through February 2019. Following PRISMA guidelines, Hedges g was calculated for each study. Primary study outcomes were the within-subject change on any symptom assessment scale for positive, negative, total, or general symptoms of schizophrenia between active drug and placebo conditions. Thirty studies were included with 434 total patients. We found a significant effect of all drugs on all scales combined with both a standard random effects model: (g = 0.26; P = 0.02; k = 22; CI = 0.03–0.49) and a more inclusive bootstrap model: (g = 0.26; P = 0.0002; k = 30; CI = 0.11–0.51) and a significant effect on total scales with the bootstrap model (g = 0.25288; P = 0.015; k = 19; CI = 0.04–0.35). We also observed a significant effect of all drugs on all positive scales combined with both the random effects (g = 0.33; P = 0.015; k = 17; CI = 0.07–0.60) and bootstrap models (g = 0.32; P < 0.0001; k = 21; CI = 0.13–1.38). This evidence provides support for further testing in randomized clinical trials of a new class of non-D2-receptor drugs, based on opioid mechanisms, for the treatment of positive and negative symptoms of schizophrenia.

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“…B-endorphin in doses of 1.5-9 mg was reported to benefit three of four schizophrenics in an uncontrolled study [Kline et al, 19771. However, controlled studies found B-endorphin to produce little or no effect [Gerner et al, 1980;Pickard et al, 19811. There is also controversial evidence that naloxone and naltrexone may have a slight effect on auditory hallucinations in some schizophrenic patients [Janowsky et al, 1977;Pickar et al, 19821 as well as thought disorder [Kleinman et al, 19821 Positive results have mainly been found in neuroleptic-treated patients. However, controlled studies with the long-acting opiate antagonist, naltrexone, have been negative, even in neuroleptic-treated schizophrenics [Gitlin et al, 19811. There have been numerous studies of the antipsychotic efficacy of (des-tyr)-gammaendorphin (DTGE) in schizophrenia.…”

Section: Endorphins and Opiate Antagonistsmentioning

confidence: 99%

Novel approaches to the pharmacotherapy of schizophrenia

Meltzer

1986

Drug Development Research

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Meltzer, H.Y.: Novel approaches to the pharmacotherapy of schizophrenia. Drug Dev.Res. 9:23-40, 1986. Numerous attempts to extend the pharmacotherapy of schizophrenia beyond conventional neuroleptics are reviewed. Clozapine and melperone are atypical neuroleptics that produce few extrapyramidal side effects during acute usage and possibly less tardive dyskinesia with prolonged use. Decreasing dopamingeric activity with a tyrosine hydroxylase inhibitor or dopamine autoreceptor agonists may also be of value. Neuroleptics that block voltage-sensitive calcium channels or calcium channel blockers per se have been advocated for treatment of negative symptoms or the deficit state. Among other possible clinical approaches reviewed are: beta adrenergic blockers, clonidine, tryptophan, 5-hydroxytryptophan, fenfluramine, GABA drugs, including high dose benzodiazepines, lithium, carbamazepine, opioid agonists and antagonists, gamma-endorphins, TRH analogs and vasopressin. Most studies indicate these agents produce inconsistent or slight-to-modest benefits, either in comparison with standard neuroleptic drugs or in addition to neuroleptics, in groups of schizophrenic patients, including some double blind placebo-controlled trials. Those individuals who do respond sometimes, but not always, fail to relapse when the experimental drug is discontinued or fail to respond to it in subsequent trials. Consistent with the presumed heterogeneity of schizophrenia, there is some evidence supporting non-neuroleptic drug treatment for specific schizophrenic subtypes. The various stages of this usually life-long disorder, together with the possible mutability of the underlying etiological factors over time, requires the utmost care in clinical trials.

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Negative naloxone effects in schizophrenic patients

Cited by 34 publications

References 4 publications

Neuroendocrine Symposium of the Signe and Ane Gyllenberg Foundation

Neuroendocrine Symposium of the Signe and Ane Gyllenberg Foundation

Opioid antagonists are associated with a reduction in the symptoms of schizophrenia: a meta-analysis of controlled trials

Novel approaches to the pharmacotherapy of schizophrenia

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