Nuller Y L, Morozova M G, Kushnir O N, Hamper N
Bekhterev Psychoneurological Research Institute, St-Petersburg, Russia.
J Psychopharmacol. 2001 Jun;15(2):93-5. doi: 10.1177/026988110101500205.
To test the hypothesis of the role for the opioid system in the pathogenesis of depersonalization, the effect of naloxone (an opioid receptor blocker) on the symptoms and corticosteroids secretion was studied in patients with depersonalization syndrome. Fourteen depersonalization patients were treated with naloxone: 11 patients received single doses (1.6 or 4 mg i.v.) and three others received multiple infusions, with the maximal dosage being 10 mg, and the effect of naloxone on symptom severity was determined. In eight patients, the cortisol, cortisone and corticosterone content in the blood plasma was determined prior to and after the 4 mg naloxone infusion. A reversed-phase microcolumn high-performance liquid chromatography with ultraviolet detection was applied for assessment of glucocorticoids. In three of 14 patients, depersonalization symptoms disappeared entirely and seven patients showed a marked improvement. The therapeutic effect of naloxone provides evidence for the role of the endogenous opioid system in the pathogenesis of depersonalization.
为检验阿片系统在人格解体发病机制中的作用这一假说，在人格解体综合征患者中研究了纳洛酮（一种阿片受体阻滞剂）对症状及皮质类固醇分泌的影响。14例人格解体患者接受了纳洛酮治疗：11例患者接受单次剂量（静脉注射1.6或4毫克），另外3例接受多次输注，最大剂量为10毫克，并确定了纳洛酮对症状严重程度的影响。在8例患者中，测定了静脉注射4毫克纳洛酮前后血浆中皮质醇、可的松和皮质酮的含量。采用反相微柱高效液相色谱法并结合紫外检测来评估糖皮质激素。14例患者中有3例人格解体症状完全消失，7例患者症状明显改善。纳洛酮的治疗效果为内源性阿片系统在人格解体发病机制中的作用提供了证据。
