Current Concepts of Cerebrovascular Disease — Stroke Opiate Antagonists in the Treatment of Stroke

DURING the past two years the rapidly growing experimental and clinical literature on the use of opiate receptor antagonists (e.g., naloxone) in the treatment of stroke has produced conflicting findings and generated a considerable degree of controversy. Some of the interlaboratory differences may have resulted from differences in methodology or design: for example, choice of species, ischemic model, or treatment dose in the experimental studies or in patient population and dose schedule in the clinical studies. Much of the present confusion may also result from a trivialization of the complexities of endogenous opioid systems or of the mechanism of action of opiate antagonists. The purpose of the present report is to summarize some of these complexities, to review critically both the experimental and clinical studies, and to suggest a more rational approach for future studies in this area.