Effects of opiates and opioids on intraocular pressure of rabbits and humans

Acute intraocular injection of morphine or D-Ala-met-enkephalinamide (D-Ala-E) in rabbits caused a sustained decrease in intraocular pressure. Conjunctival instillation of naloxone solution prevented the lowering effect of morphine or D-Ala-E on intraocular pressure. Aqueous outflow facility appeared to be significantly higher in patients addicted to morphine or heroin than in healthy volunteers. Intraocular pressure was significantly lower in addicted patients than in control subjects. Conjunctival instillation of naloxone solution decreased aqueous outflow facility and increased intraocular pressure in addicted patients. Patients with chronic open angle glaucoma showed a significant decrease in intraocular pressure after conjunctival instillation of morphine solution. It is concluded that intraocular opiate receptors are involved in the regulation of intraocular pressure in animals and humans.

Ocular instillation of naloxone increases intraocular pressure in morphine-addicted patients: a possible test for detecting misuse of morphine

The effect of conjunctival instillation of naloxone on intraocular pressure has been examined in morphine-addicted patients as compared to non-addicted healthy volunteers. Morphine-addicted subjects showed a lower basal value of intraocular pressure as compared to the control volunteers. The instillation of naloxone caused a normalization of intraocular pressure to a level similar to that of control volunteers. This test seems to be a useful screening method for detecting morphine addiction.

Effects of supidimide in schizophrenic inpatients undergoing neuroleptic maintenance therapy with haloperidol

Forty schizophrenic inpatients, on constant low-dosage maintenance therapy with haloperidol, entered a superimposed, double-blind, placebo-controlled clinical trial with supidimide 2 x 200 mg per day. The double-blind phase lasted 5 days and was preceded and followed by single-blind base line and washout periods, respectively, during which all patients received matching placebos. The therapeutic effects were evaluated by BPRS, NOSIE, a post-sleep questionnaire, and, in a subgroup of patients, by objective monitoring of movements during sleep. Supidimide substantially relieved sleep disturbances, as demonstrated by subjective (p less than 0.05; n = 20) and objective (p less than 0.1; n = 3) measurements. In addition, the following drug-related effects (p less than 0.05 versus base line and placebo) on daytime behaviour were observed: a decrease in "somatic concern" (BPRS), items related to agitation (BPRS), "irritability" and "manifest psychosis" (NOSIE), and a slight increase in "retardation" (NOSIE). No adverse effects attributable to supidimide were detected. It is concluded that supidimide exerts beneficial effects on day-time behaviour and sleep in agitated schizophrenic patients undergoing low-dosage maintenance neuroleptic therapy.