AND PSYCHOSIS *
Stanley J. Watson
Philip A. Berger
Jack D. Barchas
THE LIST of neurotransmitters or neuromodulators has grown enormously in the last few years. Yet, few of these newly discovered brain messengers have so rapidly affected behavioral sciences and biological psychiatry as have the endorphins. Clearly, the thought of having our "own natural opiates" is fascinating and carries more obvious connotations to the psychiatrist than the discovery of other substances with fewer pharmacological ramifications. After all, opiates clearly alter mood and affect, and some of them produce hallucinations and bizarre thought content. 49,74 They have been occasionally used as therapeutic tools in the past, with varying success. Furthermore, addiction to morphine or heroin is a psychiatric and social problem which pre-
sents multiple questions as to its psychological versus its physiological roots and manifestations. Finally, morphine, codeine, and other analgesics on the one hand, and heroin and other "street" opiates on the other, are closely associated in many minds with notions of pleasure and pain—notions that lie at the core of many psychological theories of normal and abnormal behavior.
It is fortunate that the endorphins are so intrinsically appealing, because they are also complex, numerous, and sometimes frustrating. In the last few years we have learned a great deal about them and from them. While they have yet to provide a key to understanding psychosis, they have taught us a great deal about brain-pituitary relationships, about the nature of neurotransmission, and peptide biosynthesis. They hold some hope for a better understanding of psychosis, an understanding which should be based on sound knowledge of the underlying physiology.
This chapter begins with a presentation of____________________