Opioid antagonist impedes exposure

J Consult Clin Psychol. 1991 Jun;59(3):425-30. doi: 10.1037//0022-006x.59.3.425.

Abstract

Exposure is a rapid and effective treatment for simple phobias. This study tested the assumption that endorphin release may be involved in exposure to a feared situation. Thirty spider-phobic Ss underwent exposure to 17 phobic-related, graded performance tasks. Half the Ss were randomly assigned to naltrexone, an opioid antagonist, and half to a placebo. Measures of heart rate, blood pressure, self-efficacy, anxiety, and cognitions were obtained during treatment. Six of the 15 Ss in the naltrexone group dropped out after the 10th step in the treatment compared with 1 of the 15 Ss in the placebo group, chi 2(1, N = 30) = 4.7, p = .03. The naltrexone group took significantly longer to complete the first 10 steps (the last step that included all Ss) compared with the placebo group, F(9, 252) = 2.17, p = .024. Maximum heart rate and anxiety were significantly greater at Step 10 in the naltrexone group, but no differences were found for self-efficacy or cognitions. The study provides further evidence that the endogenous opioid system may be involved in the process of exposure.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arousal / drug effects
  • Arousal / physiology
  • Desensitization, Psychologic / methods*
  • Endorphins / physiology*
  • Fear / drug effects
  • Fear / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Naltrexone / pharmacology
  • Personality Inventory
  • Phobic Disorders / physiopathology*
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy
  • Receptors, Opioid / drug effects
  • Receptors, Opioid / physiology*

Substances

  • Endorphins
  • Receptors, Opioid
  • Naltrexone