Ondansetron Does Not Reduce Withdrawal in Patients With Physical Dependence on Chronic Opioid Therapy

Journal of Addiction Medicine
Larry F ChuJ David Clark

Abstract

Individuals taking opioids for an extended period of time may become physically dependent, and will therefore experience opioid withdrawal should they stop taking the medication. Previous work in animal and human models has shown that the serotonin (5-HT3) receptor may be implicated in opioid withdrawal. In this study, we investigated if ondansetron, a 5-HT3-receptor antagonist, could reduce the symptoms of opioid withdrawal after chronic opioid exposure in humans. In this double-blinded, randomized, crossover study, 33 chronic back pain patients (N = 33) were titrated onto sustained-release oral morphine for 30 days. After titration, participants attended 2 study sessions, 1 week apart, in which opioid withdrawal was induced with intravenous naloxone, with or without 8 mg intravenous ondansetron pretreatment. Opioid withdrawal symptoms were assessed by a blinded research assistant (objective opioid withdrawal score [OOWS]) and by the research participant (subjective opioid withdrawal score [SOWS]). Clinically significant signs of withdrawal were observed during both the ondansetron (ΔOOWS = 3.58 ± 2.22, P < 0.0001; ΔSOWS = 12.48 ± 11.18, P < 0.0001) and placebo sessions (ΔOOWS = 3.55 ± 2.39, P < 0.0001; ΔSOWS = 12.21 ± 10.72, ...Continue Reading

Associated Clinical Trials

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Citations

Aug 11, 2020·Drugs·Reda M Chalhoub, Peter W Kalivas
Aug 9, 2019·The Journal of Pharmacology and Experimental Therapeutics·Kelly E DunnElise M Weerts
May 26, 2018·Journal of Addiction Medicine·Larry F ChuJ David Clark
May 26, 2018·Journal of Addiction Medicine·Gary Peltz
Jan 13, 2021·Cellular and Molecular Neurobiology·Lisa L WilsonJay P McLaughlin
Dec 6, 2019·Peptides·Richard J Bodnar

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