scholarly journals Pharmacological enhancement of naltrexone treatment for opioid dependence: a review

2011 ◽  
pp. 113 ◽  
Author(s):  
Paolo Mannelli ◽  
Peindl ◽  
Li-Tzy Wu
Keyword(s):  
Opioid Dependence ◽  
Naltrexone Treatment

The Stress Respond, Related To the Opioid Abstinence And Detoxification: literature review

2014 ◽  
Vol 21 (1) ◽  
pp. 86-90
Author(s):  
Robertas Badaras ◽  
Gabija Dragelytė ◽  
Indrė Vaitekonytė ◽  
Juozas Ivaškevičius ◽  
Jūratė Šipylaitė
Keyword(s):  
Opioid Dependence ◽  
Financial Resources ◽  
Successful Completion ◽  
Minimum Risk ◽  
Medical Databases ◽  
Dosing Regimens ◽  
Naltrexone Treatment ◽  
Dopaminergic Pathways ◽  
Pituitary Adrenal Axis ◽  
Opioid Detoxification

Materials and Methods. Published articles on the opioid abuse and methods of opioid detoxification were identified by searching medical databases, using corresponding literature and were also searched manually for applicable papers. The search was limited to articles published from 1985 through 2014. Results. Opioid dependence determine pathophysiologic changes in the dopaminergic pathways of the organism, as well as the alterations in the stress-responsive hypothalamic-pituitary-adrenal axis. The usage of opioid antagonists in the early stages of withdrawal, can lead the effectiveness of opioid detoxification to 100%. Rapid opioid detoxification do not remove all the symptoms of abstinence. Negative aspects, concerning the procedure, while using prevention, can be reduced to the minimum risk. Rapid opioid detoxification, comparing it with Ultrarapid opioid detoxification procedure, diverges as less financial resources and a lower risk containing technique. Conclusions. Use of antagonists may reduce the duration of withdrawal, thus reducing the overall severity of withdrawal and increasing the chances of successful completion. This technique facilitates commencement of naltrexone treatment. Dosing regimens used in clinical trials vary. Subsequent results do not correlate with the methods of detoxification.

scholarly journals Long-Acting Injectable naltrexone for the Management of patients with Opioid Dependence

2011 ◽  
Vol 5 ◽  
pp. SART.S5452 ◽  
Author(s):  
Kimberly L. Kjome ◽  
F. Gerard Moeller
Keyword(s):  
Treatment Adherence ◽  
Opioid Dependence ◽  
Opioid Antagonist ◽  
Published Data ◽  
Remission Maintenance ◽  
Increased Risk ◽  
Oral Naltrexone ◽  
Poor Treatment ◽  
Naltrexone Treatment ◽  
Long Acting

Opioid dependence is a condition with serious clinical ramifications. Treatment has focused on detoxification, agonist therapy with methadone or buprenorphine, or remission maintenance with the opioid antagonist, naltrexone. Treatment with oral naltrexone has been limited by poor treatment adherence and relapse. Studies with long-acting formulations have shown increased treatment adherence. Extended-release injectable naltrexone has been used for the treatment of alcohol dependence, and has recently received an indication for treatment of opioid dependence from the US Food and Drug Administration. Dosing occurs once monthly and existing data with long-acting naltrexone supports efficacy of treatment for opioid dependence; however published data is sparse. Treatment with long-acting naltrexone should be monitored for hepatotoxicity, and patients should be made aware of increased risk of overdose with administration of opioids during and immediately after discontinuation of long-acting naltrexone.

scholarly journals Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial

2009 ◽  
Vol 194 (6) ◽  
pp. 541-546 ◽  
Author(s):  
Nikolaj Kun⊘e ◽  
Philipp Lobmaier ◽  
John Kåre Vederhus ◽  
Bj⊘rg Hjerkinn ◽  
Solfrid Hegstad ◽  
...  
Keyword(s):  
Opioid Dependence ◽  
Controlled Trial ◽  
Opiate Dependence ◽  
Patient Treatment ◽  
Opioid Use ◽  
Heroin Use ◽  
Naltrexone Treatment ◽  
Randomised Controlled ◽  
To Receive

BackgroundNaltrexone has considerable potential in helping to prevent relapse in heroin dependency. A longer-lasting formulation for naltrexone treatment is desirable to further reduce non-adherence and relapse during treatment of opiate dependence.AimsTo evaluate the safety and effectiveness of a 6-month naltrexone implant in reducing opioid use after in-patient treatment.MethodA group of 56 abstinence-oriented patients who completed in-patient treatment for opioid dependence were randomly and openly assigned to receive either a 6-month naltrexone implant or their usual aftercare. Drug use and other outcomes were assessed at 6-month follow-up.ResultsPatients receiving naltrexone had on average 45 days less heroin use and 60 days less opioid use than controls in the 180-day period (both P<0.05). Blood tests showed naltrexone levels above 1 ng/ml for the duration of 6 months. Two patients died, neither of whom had received an implant.ConclusionsNaltrexone implant treatment safely and significantly reduces opioid use in a motivated population of patients.

scholarly journals Targeting Behavioral Therapies to Enhance Naltrexone Treatment of Opioid Dependence

2001 ◽  
Vol 58 (8) ◽  
pp. 755 ◽  
Author(s):  
Kathleen M. Carroll ◽  
Samuel A. Ball ◽  
Charla Nich ◽  
Patrick G. O'Connor ◽  
Dorothy A. Eagan ◽  
...  
Keyword(s):  
Opioid Dependence ◽  
Naltrexone Treatment ◽  
Behavioral Therapies

scholarly journals Risk-Taking Propensity as a Predictor of Induction Onto Naltrexone Treatment for Opioid Dependence

2012 ◽  
Vol 73 (08) ◽  
pp. e1056-e1061 ◽  
Author(s):  
Will M. Aklin ◽  
S. Geoffrey Severtson ◽  
Annie Umbricht ◽  
Michael Fingerhood ◽  
George E. Bigelow ◽  
...  
Keyword(s):  
Risk Taking ◽  
Opioid Dependence ◽  
Naltrexone Treatment

scholarly journals Variability of response to pharmacotherapy of naltrexone and guanfacin in patients with opioid dependence syndrome: pharmacogenetic aspect

2019 ◽  
pp. 118-121
Author(s):  
V. Ya Palatkin ◽  
A. O. Kibitov ◽  
Е. M. Krupitsky ◽  
Е. A. Blokhina Е.A. ◽  
V. M Brodyansky ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Relapse Prevention ◽  
Opioid Dependence ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Good Tolerability ◽  
Double Blind Placebo ◽  
Naltrexone Treatment ◽  
Moderate Stress

There is a problem of insufficient effectiveness of pharmacotherapy for the relapse prevention in patients with opioid dependence. In Russian Federation naltrexone is a mainly used medication for treatment of opioid addiction. However, it has no effects on stress, craving, and impulsiveness. Alpha-2 adrenoreceptor agonists can reduce the severity of these symptoms and thus might improve effectiveness of naltrexone treatment. Pharmacogenetic analysis is useful for determining potential responders and nonresponders to the treatment of opioid dependence. The aim of this study was to evaluate the variability of response to pharmacotherapy of naltrexone and guanfacin in patients with opioid dependence syndrome. This was a multicenter, randomized, double-blind, placebo-controlled clinical trial using a pharmacogenetic approach. The good tolerability and safety of naltrexone and guanfacine combination with long-term course treatment for stabilization of remission of opioid dependence was scientifically substantiated. Was showed a moderate stress-protective and anti-craving effect of guanfacin in the period of early remission with opioid dependence syndrome. Genetic analysis is useful for determining potential responders to the treatment of opioid dependence, genotyping can increase effectiveness of pharmacotherapy.

scholarly journals Exploring genetic predictors of naltrexone treatment response in opioid use disorder

2019 ◽  
pp. 61-64
Author(s):  
Е. A. Blokhina . ◽  
E. М. Krupitsky ◽  
А. O. Kibitov ◽  
V. Ya. Palatkin ◽  
T. S. Yaroslavtseva ◽  
...  
Keyword(s):  
Genetic Analysis ◽  
Treatment Outcomes ◽  
Opioid Receptor ◽  
Treatment Program ◽  
Opioid Dependence ◽  
Kappa Opioid Receptor ◽  
Controlled Clinical Trial ◽  
Opioid Use ◽  
Oral Naltrexone ◽  
Naltrexone Treatment

Purpose: The present study was aimed to evaluate the effect of the opioid receptors genes and dopamine system genes polymorphisms on the treatment outcomes of opioid dependence with implantable and oral naltrexone in randomized double blinded double dummy placebo controlled clinical trial. Methods: 306 patients with opioid dependence were randomized in 3 treatment groups (102 ss in each). The first group received implantation of 1000 mg naltrexone every 2 months during the 6 months period + oral naltrexone placebo; the second group — placebo implant every 2 months + oral naltrexone (50mg/day), and the third group — placebo implant + oral naltrexone placebo. All enrolled participants provided blood sample at baseline for genetic analysis of polymorphisms in following genes: mu-opioid receptor (OPRM1), kappa-opioid receptor (OPRK1), catechol-O-methyltransferase (COMT), dopamine receptors types 2 (DRD2) and 4 (DRD4), dopamine-beta-hydroxylase, and dopamine transporter (DAT1). Results: Regardless of provided treatment several polymorphisms of tested genes were associated with high risk of relapse: allele L (2R) DRD4 120bp (p=0.05; OR(95% CI)=3.3(1.1-10.1) ); allele С DRD2 NcoI (р=0,051 OR(95% CI) = 2,86 (1,09 — 7,52); genotype 9.9 DAT VNTR40bp (р=0,04; RR(95% CI) = 1,4(1,3 — 1,5)); on the contrary variants of polymorphisms (СС+СТ)-(ТТ)) of genes (OPRK1- DRD2Ncol) increased the chance to complete the treatment program (р=0,004; OR(95% CI) = 7.4 (1.8 — 30.4)), Kaplan-Meier survival analysis, р=0,016). The probability of completing treatment program by carriers of all these above mentioned variants of polymorphisms (OPRK1DRD2Ncol) was higher for oral naltrexone group (p=0.016), lower for double placebo group (p=0.015), but did not influence treatment outcomes in naltrexone-implant group. Conclusion: Naltrexone-implant is an effective medication for treatment of opioid dependence and its effectiveness exceeds oral naltrexone and placebo. The study showed joint influence of opioid receptor genes and genes of dopaminergic system on the treatment outcomes of opioid dependence. Genetic analysis is useful for determining potential responders to naltrexone treatment of opioid dependence.

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