The combination very low-dose naltrexone-clonidine in the management of opioid withdrawal.
dc.contributor.author | Mannelli, Paolo | |
dc.contributor.author | Peindl, Kathleen | |
dc.contributor.author | Wu, Li-Tzy | |
dc.contributor.author | Patkar, Ashwin A | |
dc.contributor.author | Gorelick, David A | |
dc.date.accessioned | 2020-02-03T06:39:12Z | |
dc.date.available | 2020-02-03T06:39:12Z | |
dc.date.issued | 2012-05 | |
dc.date.updated | 2020-02-03T06:39:11Z | |
dc.description.abstract | The management of withdrawal absorbs substantial clinical efforts in opioid dependence (OD). The real challenge lies in improving current pharmacotherapies. Although widely used, clonidine causes problematic adverse effects and does not alleviate important symptoms of opioid withdrawal, alone or in combination with the opioid antagonist naltrexone. Very low-dose naltrexone (VLNTX) has been shown to attenuate withdrawal intensity and noradrenaline release following opioid agonist taper, suggesting a combination with clonidine may result in improved safety and efficacy.We investigated the effects of a VLNTX-clonidine combination in a secondary analysis of data from a double-blind, randomized opioid detoxification trial.Withdrawal symptoms and treatment completion were compared following VLNTX (.125 or .25 mg/day) and clonidine (.1-.2 mg q6h) in 127 individuals with OD undergoing 6-day methadone inpatient taper at a community program.VLNTX was more effective than placebo or clonidine in reducing symptoms and signs of withdrawal. The use of VLNTX in combination with clonidine was associated with attenuated subjective withdrawal compared with each medication alone, favoring detoxification completion in comparison with clonidine or naltrexone placebo. VLNTX/clonidine was effective in reducing symptoms that are both undertreated and well controlled with clonidine treatment and was not associated with significant adverse events compared with other treatments.Preliminary results elucidate neurobiological mechanisms of OD and support the utility of controlled studies on a novel VLNTX + low-dose clonidine combination for the management of opioid withdrawal. | |
dc.identifier.issn | 0095-2990 | |
dc.identifier.issn | 1097-9891 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Informa UK Limited | |
dc.relation.ispartof | The American journal of drug and alcohol abuse | |
dc.relation.isversionof | 10.3109/00952990.2011.644003 | |
dc.subject | Humans | |
dc.subject | Opioid-Related Disorders | |
dc.subject | Substance Withdrawal Syndrome | |
dc.subject | Methadone | |
dc.subject | Naltrexone | |
dc.subject | Clonidine | |
dc.subject | Narcotic Antagonists | |
dc.subject | Drug Therapy, Combination | |
dc.subject | Dose-Response Relationship, Drug | |
dc.subject | Adolescent | |
dc.subject | Adult | |
dc.subject | Disease Management | |
dc.subject | Female | |
dc.subject | Male | |
dc.subject | Adrenergic alpha-2 Receptor Agonists | |
dc.subject | Opiate Substitution Treatment | |
dc.title | The combination very low-dose naltrexone-clonidine in the management of opioid withdrawal. | |
dc.type | Journal article | |
duke.contributor.orcid | Mannelli, Paolo|0000-0002-7834-6138 | |
duke.contributor.orcid | Wu, Li-Tzy|0000-0002-5909-2259 | |
pubs.begin-page | 200 | |
pubs.end-page | 205 | |
pubs.issue | 3 | |
pubs.organisational-group | School of Medicine | |
pubs.organisational-group | Duke | |
pubs.organisational-group | Center for Child and Family Policy | |
pubs.organisational-group | Sanford School of Public Policy | |
pubs.organisational-group | Duke Clinical Research Institute | |
pubs.organisational-group | Institutes and Centers | |
pubs.organisational-group | Duke Institute for Brain Sciences | |
pubs.organisational-group | University Institutes and Centers | |
pubs.organisational-group | Institutes and Provost's Academic Units | |
pubs.organisational-group | Psychiatry & Behavioral Sciences, Social and Community Psychiatry | |
pubs.organisational-group | Psychiatry & Behavioral Sciences | |
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | Medicine, General Internal Medicine | |
pubs.organisational-group | Medicine | |
pubs.organisational-group | Family Medicine and Community Health, Community Health | |
pubs.organisational-group | Family Medicine and Community Health | |
pubs.organisational-group | Faculty | |
pubs.publication-status | Published | |
pubs.volume | 38 |
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