Effects of Pentazocine on Manic Symptoms

This study has been completed.
Stanley Medical Research Institute
Information provided by (Responsible Party):
Beth L. Murphy MD, PhD, Mclean Hospital
ClinicalTrials.gov Identifier:
First received: August 1, 2005
Last updated: April 20, 2012
Last verified: April 2012

The opiate neurotransmitter system is thought to be involved in many abnormal mood states. Some researchers have suggested that changes in this system may trigger the switch to/from manic and depressive states in bipolar disorder. One problem with most of the currently available opiate medications is that they can produce addiction/dependence. A particular kind of opiate medication known as kappa-opiates may be able to produce changes in this system with much less risk of addiction. This study looks at Talwin (a combination of pentazocine and naloxone), a medication which affects the kappa and mu opiate systems. The study will examine whether two doses of Talwin affect manic symptoms in people who have been admitted to the hospital. This study will give more information about the involvement of the opiate system in bipolar disorder, and give important information for use in developing new treatments.

Condition Intervention Phase
Bipolar Disorder
Drug: Talwin Nx
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Inpatient Clinical Trial Examining the Effects of Pentazocine on Manic Symptoms

Resource links provided by NLM:

Further study details as provided by Mclean Hospital:

Primary Outcome Measures:
  • mania rating scale [ Time Frame: hourly-daily ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • hours of sleep [ Time Frame: nightly ] [ Designated as safety issue: No ]
  • use of adjunctive 'as needed' medications [ Time Frame: daily ] [ Designated as safety issue: No ]
  • mania symptoms self-report [ Time Frame: hourly-daily ] [ Designated as safety issue: No ]

Enrollment: 10
Study Start Date: September 2005
Study Completion Date: December 2008
Primary Completion Date: August 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Talwin NX
Drug: Talwin Nx
Talwin NX 50mg po twice

Detailed Description:

Opiates have a long history of treating mood disorders. Some researchers have suggested that changes in this system may trigger the switch to/from manic and depressive states in bipolar disorder. The clinical use of opiate medications has been limited by their abuse/dependence potential. Studies of opiate receptor subtypes have raised the possibility that medications targeting the kappa/dynorphin system could be used to target mood symptoms with reduced/limited addiction potential. Rodent studies at Mclean indicate that kappa-agonists have pro-depressant effects and kappa-antagonists have anti-depressant effects. In addition, antimanic/antipsychotic medications regulate the activity of dynorphin cells. This study is a pilot open-label investigation using Talwin, a combination of pentazocine and naloxone. Pentazocine is a kappa agonist and mixed mu agonist. Two doses of Talwin will be given to acutely manic inpatients in a cumulative-dosing strategy. Measurements of manic symptoms will be conducted before, during, and after administration. This study will determine whether pentazocine has an immediate or sustained impact on acute mania symptoms.


Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Young Mania Rating Scale (YMRS) greater than 14
  • Inpatient

Exclusion Criteria:

  • History of opiate abuse/dependence
  • Recent history of substance abuse
  • Pregnancy
  • Unstable medical issues
  • Use of opiate medications for pain management
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00125931

Sponsors and Collaborators
Mclean Hospital
Stanley Medical Research Institute
Principal Investigator: Beth L Murphy, MD, PhD Mclean Hospital
  More Information

Additional Information:
Responsible Party: Beth L. Murphy MD, PhD, Principal Investigator, Mclean Hospital
ClinicalTrials.gov Identifier: NCT00125931     History of Changes
Other Study ID Numbers: 2005P-001260
Study First Received: August 1, 2005
Last Updated: April 20, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Mclean Hospital:
bipolar disorder
manic state

Additional relevant MeSH terms:
Bipolar Disorder
Affective Disorders, Psychotic
Mood Disorders
Mental Disorders
Analgesics, Opioid
Central Nervous System Depressants
Physiological Effects of Drugs
Pharmacologic Actions
Sensory System Agents
Peripheral Nervous System Agents
Central Nervous System Agents
Therapeutic Uses
Adjuvants, Anesthesia
Narcotic Antagonists

ClinicalTrials.gov processed this record on August 25, 2014