Alcohol abuse naltrexone

Petrakis IL, O Malley S, Rounsaville B, et al Naltrexone augmentation of neuroleptic treatment in alcohol abusing patients with schizophrenia. Psychopharmacology (Berl) 172 291-297, 2004... 

Kleber HD, Weissman MM, Rounsaville BJ, et al Imipramine as treatment for depression in addicts. Arch Gen Psychiatry 40 649-633, 1983 Kleber HD, Riordan CE, Rounsaville BJ, et al Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 42 391-394, 1983 Kleber HD, Topazian M, Gaspari J, et al Clonidine and naltrexone in the outpatient treatment of heroin withdrawal. Am J Drug Alcohol Abuse 13 1-17, 1987 Kornetsky C. Brain stimulation reward, morphine-induced stereotypy, and sensitization implications for abuse. Neurosci Biobehav Rev 27 777-786, 2004 Kosten TR, Kleber HD Buprenorphine detoxification from opioid dependence a pilot study. Life Sci 42 633-641, 1988... 

Naltrexone is prescribed at a dose of 50 mg once per day for at least 12 weeks as part of a comprehensive alcohol treatment program. Like all treatments for substance use disorders, it works only as well as the addict allows it to work. This is why it is important to use it as a component of an overall treatment plan. Otherwise, poorly motivated alcohol abusers will seldom remain adherent with naltrexone and it will have little chance of providing benefit. A long-acting depot formulation of naltrexone currently in development might improve these compliance problems. 

Wold, M. and Kaminer, Y. (1997) Naltrexone for alcohol abuse letter to the editor. / Am Acad Child Adolesc Psychiatry 36 6-7. 

A number of narcotic antagonists based on the morphinan stmcture have been marketed—for example, Buprenorphine, Naloxone, Naltrexone, and Nalorfine. Nalmefene is being pursued for the treatment of alcohol abuse. Oxycodone, and its precursor Codeine, are marketed, with restrictions, as analgesics. noSee Chapter 9, Table 3. 

The potential utility of delta antagonists for the treatment of alcohol abuse has excited considerable interest over the last decade for at least two reasons. First, numerous studies suggest that the abuse-related effects of alcohol are mediated, at least in part, by endogenous opioid systems [114]. Second, the relatively nonselective opioid antagonist naltrexone has acknowledged clin-... 

Volpicelli JR, O Brien CP, Alterman AI, Hayashida M (1990) Naltrexone and the treatment of alcohol dependence initial observations. In Reid LD (ed) Opioids, bulimia, and alcohol abuse addiction. Springer, New York, NY, pp 195-214... 

The subsequent introduction of naloxone s cyclopropylmethyl analog, naltrexone (Trexan, Fig. 5-9), with its ready oral absorption and considerably longer duration of action has made possible the use of a pure antagonist in the treatment of narcotic addicts. Naltrexone in once-a-day oral doses of 50 mg will produce satisfactory clinical blockade of intravenously administered opiates.10 In fact, a single dose of 100 or 150 mg can be used on a once, every other, or third-day basis. This drug may represent a small advance in the battle against opiate dependency. Naltrexone has been approved (1994) to obtund the cravings of alcohol abusers. 

Opioid antagonists have established uses in the treatment of opioid-induced toxicity, especially respiratory depression in the diagnosis of physical dependence on opioids and as therapeutic agents in the treatment of compulsive users of opioids (Chapter 23). Naltrexone is also FDA-approved for the treatment of alcohol abuse. 

Following detoxication, the use of naltrexone may decrease the craving for alcohol The most important goal in alcohol withdrawal is to prevent respiratory depression Wernicke-Korsakoff syndrome that occurs in alcohol abuse is due to a deficiency of folic acid... 

Schecter, A. J., Friedman, J.G. and Gross-man, D. J. (1974) Clinical Use of Naltrexone (EN-1639A) Part 1 Safety and efficacy in pilot studies. Awez. J. Drug Alcohol Abuse, 1, 253. 

Umbricht A, Hoover DR, Tucker MJ, et al Opioid detoxification with buprenorphine, clonidine, or methadone in hospitalized heroin-dependent patients with HIV infection. Drug Alcohol Depend 69 263-272, 2003 Villagomez RE, Meyer TJ, Lin MM, et al Post-traumatic stress disorder among inner city methadone maintenance patients. Subst Abuse Treat 12 253—257, 1995 Mining E, Kosten TR, Kleber H Clinical utility of rapid clonidine-naltrexone detoxification for opioid abusers. Br J Addict 83 567-575, 1988 Washton AM, Pottash AC, Gold MS Naltrexone in addicted business executives and physicians. J Clin Psychiatry 45 39 1, 1984 Wesson DR Revival of medical maintenance in the treatment of heroin dependence (editorial). JAMA 259 3314-3315, 1988... 

Finally, as noted earlier, comorbid substance abuse, particularly with bipolar male patients, is a strong predictor of suicide-related lethality. It is critically important to recognize these complicating disorders and aggressively intervene with appropriate clinical strategies. Referral to Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other related counseling support programs, as well as prescription of naltrexone (Revia) in the appropriate patients, may also help to diminish the risk of serious morbidity (see also the section The Alcoholic Patient in Chapter 14). 

Oslin DW, Pettinati HM, Volpicelli JR, et al. The effects of naltrexone on alcohol and cocaine use in dually addicted patients. J Subst Abuse Treat 1999 16 163-167. 

The 17 - N- a 11 y I - (n a I o x o n e. 3a) and 17 - /V-c v c lop I opv I m e t h v I (naltrexone, 3b) analogues of oxymorphone (2d) are the prototype opioid receptor antagonists with some selectivity for MOR. They have entered clinical practice as treatments for narcotic overdose (naloxone) and alcoholism or opioid abuse/dependence (naltrexone). The 17-quatemary derivative of naltrexone, methylnaltrexone (4) has recently been introduced into clinical practice as a treatment for opiate-induced bowel dysfunction [1],... 

Alcohol, Naltrexone is a p-opioid receptor antagonist first synthesized in the opioid 1960s. Naltrexone was approved by the FDA for the treatment of opioid addiction treatment in 1984 and alcohol addiction in 1994 [247]. Naltrexone blocks the euphoric effects of opioids by binding competitively to opioid receptors, but does little to curb craving for opioids. Because naltrexone is an opioid antagonist there is little risk of abuse or dependence given that it does not have intrinsic opiate effects and therefore is not reinforcing [248]. 

Chick J, Anton R, Checinski K, Croop R, Drummond DC, Farmer R, Labriola D, Marshall J, Moncrieff J, Morgan MY, Peters T, Ritson B (2000) A multicentre, randomized, double-blind, placebo-controlled trial of naltrexone in the treatment of alcohol dependence or abuse. Alcohol Alcohol 35 587-593... 

Attention to nutritional needs is not totally protective against organ system damage that occurs with chronic abuse of alcohol. Females are more susceptible to alcohol hepatotoxicity than males. Respiratory depression is a symptom of ethanol overdose, not withdrawal. Naltrexone, an opioid receptor antagonist, may have value in some patients to decrease the intensity of craving. The answer is (C). 

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