Naltrexone therapy of apnea in children with elevated cerebrospinal fluid beta-endorphin

Title

Naltrexone therapy of apnea in children with elevated cerebrospinal fluid beta-endorphin

Creator

Myer EC; Morris DL; Brase DA; Dewey WL; Zimmerman AW

Publisher

Annals Of Neurology

Date

1990

Subject

Child; Female; Humans; infant; Male; Prospective Studies; Preschool; infant; Biomarkers of Pain; Newborn; beta-Endorphin/cerebrospinal fluid; Leigh Disease/cerebrospinal fluid; Naltrexone/therapeutic use; Sleep Apnea Syndromes/cerebrospinal fluid/drug therapy

Description

Previous studies have indicated increased immunoreactivity of the endogenous opioid peptide beta-endorphin in the cerebrospinal fluid (CSF) of infants under 2 years of age with apnea. To assess the role of endogenous opioids in the pathogenesis of apnea in children, the effect of oral treatment with the opioid antagonist naltrexone was studied in apneic infants, as well as in older apneic children, with demonstrated increases in CSF immunoreactive beta-endorphin (i-BE). In the 8 apneic infants with elevated i-BE in lumbar CSF (range, 55-155 pg/ml; normal, 17-52 pg/ml), no further apnea occurred during naltrexone therapy (1 mg/kg/day, by mouth). Five children (2-8 years old) with apnea of unknown cause had elevated CSF i-BE (range, 74-276 pg/ml) compared to 6 age-matched nonapneic children (range, 15-48 pg/ml). No apneic events occurred during naltrexone therapy, except in 1 child during stressful events, but apnea recurred in some patients after attempts to discontinue naltrexone treatment. Adverse effects of naltrexone included complaints of headaches in 2 children and symptoms of a narcotic withdrawal syndrome during the first 3 days of treatment in 1 child. Three children with Leigh's syndrome had elevated CSF i-BE (range, 104-291 pg/ml) and their apnea also responded to naltrexone. We conclude that elevated endogenous opioids contribute to the pathogenesis of apnea in children and may even result in physical dependence.
1990

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

75-80

Issue

1

Volume

27

Citation

Myer EC; Morris DL; Brase DA; Dewey WL; Zimmerman AW, “Naltrexone therapy of apnea in children with elevated cerebrospinal fluid beta-endorphin,” Pediatric Palliative Care Library, accessed May 18, 2022, https://pedpalascnetlibrary.omeka.net/items/show/12551.

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