Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial.

Addiction Biology
Paolo MannelliEdward Gottheil

Abstract

Although current treatments for opioid detoxification are not always effective, medical detoxification remains a required step before long-term interventions. The use of opioid antagonist medications to improve detoxification has produced inconsistent results. Very low dose naltrexone (VLNTX) was recently found to reduce opioid tolerance and dependence in animal and clinical studies. We decided to evaluate safety and efficacy of VLNTX adjunct to methadone in reducing withdrawal during detoxification. In a multi-center, double-blind, randomized study at community treatment programs, where most detoxifications are performed, 174 opioid-dependent subjects received NTX 0.125 mg, 0.250 mg or placebo daily for 6 days, together with methadone in tapering doses. VLNTX-treated individuals reported attenuated withdrawal symptoms [F = 7.24 (2,170); P = 0.001] and reduced craving [F = 3.73 (2,107); P = 0.03]. Treatment effects were more pronounced at discharge and were not accompanied by a significantly higher retention rate. There were no group differences in use of adjuvant medications and no treatment-related adverse events. Further studies should explore the use of VLNTX, combined with full and partial opioid agonist medications, in de...Continue Reading

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Citations

Apr 11, 2013·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Paolo MannelliDavid A Gorelick
Jul 1, 2012·Industrial Psychiatry Journal·Siddharth Sarkar, Surendra K Mattoo
Mar 20, 2012·Drug and Alcohol Dependence·Angela L StottsJoy M Schmitz
Oct 24, 2012·British Journal of Clinical Pharmacology·Nikolaj KunøeGary Hulse
Sep 18, 2009·Human Psychopharmacology·Paolo MannelliRima Kaddurah-Daouk
Jan 12, 2012·The American Journal of Drug and Alcohol Abuse·Paolo MannelliDavid A Gorelick
Mar 30, 2018·The American Journal on Addictions·Adam BisagaThomas R Kosten
Jun 22, 2018·The Cochrane Database of Systematic Reviews·Afarin Rahimi-MovagharMasoumeh Amin-Esmaeili
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Mar 2, 2013·The Cochrane Database of Systematic Reviews·Laura AmatoMarica Ferri
May 30, 2017·The Cochrane Database of Systematic Reviews·Linda GowingJason M White
Sep 27, 2018·Medical Sciences : Open Access Journal·Karlo Toljan, Bruce Vrooman

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