Clinical pharmacology of beta-endorphin in depression and schizophrenia.
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Biomedical subjects
Publications and source records attributed to D A Gorelick.
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Ten depressed and eight schizophrenic patients received synthetic human beta-endorphin infusions in a double-blind, placebo-controlled, crossover design. Physicians' and nurses' ratings and patients' self-ratings were used to measure behavioral change. Depressed patients improved significantly two to four hours after beta-endorphin treatment when compared with placebo treatment. There was no significant change in the schizophrenic patients as a group, although six of eight worsened after beta-endorphin treatment. No significant behavioral effects were observed during the infusions themselves or on postinfusion days.
In a randomized, double blind, cross-over study, human beta-endorphin or saline was infused iv over 30 min into six depressed psychiatric patients and four methadone addicts. All depressed subjects showed prompt, 2- to 4-fold increases in serum PRL levels, which lasted at least 2 h. The addicts, who were undergoing acute methadone withdrawal, showed similar PRL increases, which were dose dependent. beta-Endorphin did not increase serum levels of cortisol or GH in either group of subjects. These results suggest that iv beta-endorphin has potent but selective neuroendocrine effects in depressed patients and subjects withdrawing from methadone.
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Pairs of male Sprague-Dawley rats were administered mescaline, lysergic acid diethylamide (LSD), psilocin, N,N-dimethyltryptamine (DMT), 3,4-dimethoxyphenylethylamine (DMPEA), or 5-hydroxydopamine (5-OHDA) IP prior to being placed in a shock-elicited aggression situation. When foot shock was delivered, controls struck each other with their forepaws, but never engaged in either biting or injurious fighting. Mescaline-treated rats (50 or 250 mg) rarely struck each other, but engaged in nearly lethal biting. While LSD (25--400 micrograms/kg), psilocin (2.0 mg/kg), and DMT (5 mg/kg) produced some biting, this did not significantly differ from controls and never resulted in injuries. At higher doses, psilocin, DMT, and DMPEA decreased the amount and intensity of fighting. Rats treated with 5-OHDA (8--200 mg/kg) or LSD (25--400 micrograms/kg) did not differ from controls. These results suggest that mescaline's ability to induce pathological aggression in rats exposed to foot shock is not shared by other hallucinogens or nonhallucinogenic mescaline analogues.
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Male Sprague-Dawley rats received 14 daily intravenous injections of saline or human beta-endorphin (2.5 mg/kg). Animals were given one-way active avoidance training on the eleventh day, and analgesia testing on the twelfth (tail-flick) and thirteenth (hot-plate) days. Beta-endorphin had no effect on the number of trials needed to reach the avoidance criterion, but significantly lengthened response latencies. Beta-endorphin had no analgesic effect in either test procedure.
The 83-year-old woman in this case report developed paranoid delusions and auditory hallucinations in association with toxic serum levels of digoxin, while remaining alert, unagitated, and coherent in thinking. No cardiovascular or metabolic abnormalities were discovered to account for her psychiatric symptoms. Her mental status rapidly returned to normal as serum digoxin declined to therapeutic levels.
The effects of mescaline hydrochloride (4.95-79.2 mg/kg i.p.) and its non-hallucinogenic analogue 3,4-dimethoxyphenylethylamine hydrochloride (DMPEA) (12.5-100 mg/kg i.p.) on shock avoidance in a shuttlebox were studied in male Long-Evans rats trained to high (above 88%, good performers) or low (below 6%, poor performers) stable base-line avoidance rates. In good performers, mescaline and DMPEA caused a dose-dependent decrease in avoidance rate (ED 50's 44.6 and 39.2 mg/kg, respectively) without affecting presession (5-min adaptation period) or intertrial shuttlebox crossings. In poor performers, mescaline caused a dose-dependent increase in avoidance rate (ED 50 = 24.8 mg/kg) and intertrial crossings, without affecting presession crossings. The results suggest that mescaline, but not DMPEA, has dual facilitative and disruptive effects on avoidance behavior at similar dose ranges. The facilitative, but not the disruptive, effect may be related to changes in motor activity.
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This experiment is related to the hypothesis of Bridger and of Wray that hallucinogens have facilitatory effects on animal behavior when stress is part of the experiment and have disruptive effects otherwise. Male Long-Evans rats were trained to high (above 89%), stable base line rates of shuttlebox avoidance, then given each of four treatments at 6-day intervals after returning to base line avoidance rates: 1. saline (1 ml i.p.), 2. saline+stressor, 3. mescaline hydrochloride (36.6 mg/kg i.p.), 4. mescaline (39.6 mg/kg i.p.)+stressor. Stress treatment was 1.0 mA footshock (1 sec duration) every 20-30 sec for 15 min between injection and session. Sessions (100 trials) began 20 min after injection. Treatments 1 and 2 had no effect on avoidance rate. Treatments 3 and 4 significantly decreased avoidance rate, with the latter causing significantly more decrease than the former. None of the treatments affected presession (5 min adaptation period) or intertrial crossings of the shuttlebox or latency on escape trials. These results suggest that exposure to a stressor, per se, is not the crucial factor causing hallucinogens to have facilitatory effects on animal behavior.
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Major problems for research on pharmacological treatments for cocaine dependence are lack of comparability of results from different treatment research programs and poor validity and/or reliability of results. Double-blind, placebo-controlled, random assignment, experimental designs, using standard intake and assessment procedures help to reduce these problems. Cessation or reduction of drug use and/or craving, retention in treatment, and medical and psychosocial improvement are some of the outcome variables collected in treatment research programs. A model to be followed across different outpatient clinical trials for pharmacological treatment of cocaine dependence is presented here. This model represents an effort to standardize data collection to make results more valid and comparable.