High-dose naloxone in tardive dyskinesia.
Tardive dyskinesia (TD) is thought to result from nigrostriatal dopaminergic supersensitivity secondary to prolonged neuroleptic exposure. Preclinical studies have demonstrated that the opiate antagonist naloxone can acutely reverse a haloperidol-induced hyperdopaminergic state. In a trial of high-dose naloxone, 20 patients with TD received i.v. naloxone (20 mg, 40 mg, and placebo) under double-blind conditions. At baseline and at regular postdrug intervals, patients were evaluated using a battery of motor, clinical, and neuropsychological measures to study effects on neurological, behavioral, and cognitive functions. There was a significant improvement in involuntary movements at 30 min postnaloxone, together with improvement in clinical ratings at that time point, as well as some cognitive changes. The implications of these findings for the putative functional relationship between dopaminergic and enkephalinergic systems in the nigrostriatal area are discussed.
Lindenmayer
J P
JP
Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY.
Gardner
E
E
Goldberg
E
E
Opler
L A
LA
Kay
S R
SR
van Praag
H M
HM
Weiner
M
M
Zukin
S
S
D000328:Adult; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D008875:Middle Aged; D009048:Motor Skills / Q000187:drug effects; D009270:Naloxone / Q000627:therapeutic use*; D011340:Problem Solving / Q000187:drug effects; D011581:Psychological Tests; D011897:Random Allocation
D009270:Naloxone