Opioid antagonists in broadly defined behavioral addictions: a narrative review

Expert Opinion on Pharmacotherapy
Marcelo Piquet-Pessôa, Leonardo F Fontenelle

Abstract

Naltrexone (NTX), a mu-opioid receptor antagonist, has been approved for the treatment of alcoholism and opioid dependence. More recently, however, NTX and a related drug, nalmefene (NMF), have also shown positive results for the treatment of gambling disorders. In this study, we reviewed the trials testing the effect of opioid antagonists (OA) in gambling disorders and in other broadly defined behavioral addictions, including selected DSM-5 disruptive, impulse-control, and conduct disorders, obsessive-compulsive and related disorders, eating disorders, and other conditions not currently recognized by official classification schemes. We found six randomized controlled trials (RCTs) of OA in gambling disorder, two RCTs of OA in trichotillomania (hair pulling disorder), two RCTs of OA in binge eating disorder, and one RCT of OA for kleptomania. We also reviewed case reports on hypersexual disorder, compulsive buying and skin picking disorders. The reviewed data supported the use of OA, namely NTX and NMF, in gambling disorder (both) and kleptomania (NTX). We did not find enough evidence to support the use of NTX or NMF in trichotillomania (hair pulling disorder), excoriation (skin-picking) disorder, compulsive buying disorder, hy...Continue Reading

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Citations

Mar 17, 2017·The American Journal of Drug and Alcohol Abuse·Arnaud LeroyOlivier Cottencin
Feb 12, 2020·CNS Spectrums·Gabriela M FerreiraLeonardo F Fontenelle
Jan 24, 2020·Journal of Addiction Medicine·Kurosch YazdiNikolas W Gerstgrasser
Jan 10, 2017·CNS Spectrums·Gabriela M FerreiraLeonardo F Fontenelle
Aug 10, 2018·F1000Research·José M MenchonSusana Jiménez-Murcia
Apr 30, 2020·International Journal of Molecular Sciences·Audrey VerhollemanMarie Grall-Bronnec
Dec 9, 2020·Journal of Behavioral Addictions·Norman R GreenbergMarc N Potenza

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