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We studied the role of the endogenous opioidergic system in stress\u2010induced analgesia in 14 healthy participants in a double\u2010blind cross\u2010over trial. Naloxone or placebo was applied while electrical pain stimulation was started and electrical current increased. After reaching a constant stimulation at 30\u2009mA, a color word interference test (<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>troop task) was performed in a stressful and a non\u2010stressful version. Blood pressure, heart rate and baroreflex sensitivity were continuously recorded to assess autonomic activation. Each participant was tested with naloxone and placebo with a randomized and balanced order of trials.<\/jats:p><jats:p>The major results are that the opioid\u2010receptor antagonist naloxone prevented (1) stress\u2010induced reduction of tonic current\u2010induced pain, (2) attenuated the simultaneous activation of the sympathetic nervous system, and (3) reduced the counteraction of sympathetic activation by vagal baroreceptor mechanisms. Thus, the opioidergic system not only modulates nociceptive input but also the interplay with vegetative responses.<\/jats:p><jats:p>We conclude that acute stress, sympathetic activation and analgesia might be linked via vagal reflexes, which are disturbed when opioid receptors are blocked. This mechanism might underlie increased perception of noxious stimuli in patients with chronic pain or mood disorders.<\/jats:p>","DOI":"10.1016\/j.ejpain.2011.06.009","type":"journal-article","created":{"date-parts":[[2011,7,15]],"date-time":"2011-07-15T09:14:57Z","timestamp":1310721297000},"page":"82-92","source":"Crossref","is-referenced-by-count":28,"title":["Naloxone inhibits not only stress\u2010induced analgesia but also sympathetic activation and baroreceptor\u2010reflex sensitivity"],"prefix":"10.1002","volume":"16","author":[{"given":"M.","family":"Fechir","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg\u2010University Mainz Langenbeckstrasse 1 D\u201055101 Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Breimhorst","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg\u2010University Mainz 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