Injection of naloxone, nalmefene or diprenorphine was successful in treating crib biting (aerophagia assisted by gripping an object between the incisor teeth) and hyperkinesis in horses. Yawning, sedation and penile relaxation occurred 10-30 minutes treatment, coinciding with disappearance of crib biting. Then the horses became bright and alert and did not crib for 20 minutes after naloxone, or up to 4 hours after nalmefene or diprenorphine (1). Naltrexone and nalmefene significantly reduced the time spent self-licking, self-chewing or scratching in dogs but the effect wore off after 60 - 90 minutes (2). Nalmefene reduced self mutilation in a stallion and the effect was dose-related but lasted only 4 hours or so (3). Thus, opiate antagonists have clear but short-term therapeutic effect in stereotypic disorder. The outcome of long-term opiate antagonist therapy requires further research.
The endogenous opiate system is involved in stereotypies but whether as cause or effect is not clear (2). It is suggested that stereotypic behaviour, such as aerophagia, crib biting, hyperkinesis, self mutilation etc activates the brain's pleasure centres and other opiate centres in nervous tissues. Repetitive self-gratification may become an intractable vice, a state analogous to long-term opiate dependency. Many drugs act as opiate antagonists. They include naloxone, naltrexone, nalmefene and diprenorphine. Opiate antagonists displace opiates from their receptor sites, abolishing the pleasurable effect of the opiates or their inductive behaviour. This may be why opiate antagonists can suppress or reduce stereotypic disorders (1,2,3).
Yin-Yang theory proposes that everything has its opposite. Endogenous opiate mechanisms of acupuncture (AP) have been confirmed, hence one might suspect that anti-endogenous opiate mechanisms also exist. The high success of AP in reversing narcotic apnoea (4) and in detoxifying narcotic addicts (6, 10) is strong evidence of this.
AP therapy was very successful in treating aerophagia in horses which also had gastrointestinal disturbance but gave poor results in those which had normal gastrointestinal function (5). Thus, AP may activate an anti-opiate mechanism rather than the opiate mechanism suggested by Kuussaari (5). In contrast to anti-opiate drug therapy (1, 2, 3), the results to three AP sessions were longlasting. AP has reflex effects (autonomic, anti-inflammatory etc) on irritated target organs (7, 8, 9). These reflex effects may explain the longlasting results of AP.
Prolonged electro-stimulation at Earpoint Lung or the mastoid processes is highly successful in alcoholic and narcotic detoxification. This suggests that these points should be researched in relation to treating other stereotypic disorders, such as self-gratifying vices and self-mutilation in humans and animals.
Signed :
........................
Philip A.M. Rogers MRCVS
1 Esker Lawns, Lucan,
Dublin, Ireland.
........................
Jukka Kuussaari DVM
24560 Toija,
Finland.
................................
Nicholas Dodman BVMS, MRCVS, DVA
Department of Surgery,
School of Veterinary Medicine,
Tufts University,
200 Westboro Rd.,
North Grafton,
MA 01536, U.S.A.
REFERENCES
1. Dodman, N.H., Shuster, L, Court, M.H. and Dixon, R. (1988) Investigation into the use of narcotic antagonists in the treatment of a stereotypic behaviour pattern (crib-biting) in the horse. Amer. J. Vet. Res., 48, 311-.
2. Dodman, N.H., Shuster, L, White, S.D., Court, M.H., Parker, L. and Dixon, R. (1988) Use of narcotic antagonists to modify stereotypic self-licking, self-chewing and scratching behaviour in dogs. J. Amer. Vet. Med. Assoc., 193, 815-.
3. Dodman, N.H., Shuster, L, Court, M.H. and Patel, J. (1988) Use of a narcotic antagonist (nalmefene) to suppress self-mutilative behaviour in a stallion. J. Amer. Vet. Med. Assoc., 192, 1585-.
4. Janssens, L., Altman, S. and Rogers, P.A.M. (1979) Respiratory and cardiac arrest under general anaesthesia : treatment by AP of nasal philtrum. Vet. Rec., 105, 273-.
5. Kuussaari, J. (1983) AP treatment of aerophagia in horses. Amer. J. Acup., 11, 363-.
6. Lau, M.P. (1976) AP and addiction - an overview. Addictive Diseases : an International J., 2, 449-.
7. Lin, J.H. and Rogers, P.A.M. (1980) AP effects on the body's defence systems. A veterinary review. Vet. Bulletin 50, 633-.
8. Rogers, P.A.M., White, S.S. and Ottaway, C.W. (1977) Stimulation of the acupoints in relation to analgesia and therapy of clinical disorders in animals. Vet. Annual (Wright Scitechnica, Bristol) 17, 258-279.
9. Rogers, P.A.M. and Bossy, J. (1981) Activation of the defence systems of the body in animals and man by acupuncture and moxibustion. Acup. Res. Quarterly (Taiwan) 5, 47-54.
10. Smith, M.O. (1988) AP treatment for Crack : clinical survey of 1500 patients treated. Amer. J. Acup., 16, 241-.