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Nalmefene

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https://www.readbyqxmd.com/read/29120249/alcohol-addiction-the-safety-of-available-approved-treatment-options
#1
Mariangela Antonelli, Anna Ferrulli, Luisa Sestito, Gabriele A Vassallo, Claudia Tarli, Carolina Mosoni, Maria M Rando, Antonio Mirijello, Antonio Gasbarrini, Giovanni Addolorato
Alcohol Use Disorder (AUD) is a leading cause of mortality and morbidity worldwide. At present disulfiram, naltrexone and acamprosate are approved for the treatment of AUD in U.S. and Europe. Nalmefene is approved in Europe and sodium oxybate is approved in Italy and Austria only. Baclofen received a "temporary recommendation for use" in France. Areas covered. The safety of the medications mentioned above on liver, digestive system, kidney function, nervous system, pregnancy and lactation and their possible side effects are described and discussed...
November 9, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29080208/who-receives-nalmefene-and-how-does-it-work-in-the-real-world-a-single-arm-phase-iv-study-of-nalmefene-in-alcohol-dependent-outpatients-baseline-and-1-month-results
#2
Pablo Barrio, Lluisa Ortega, Josep Guardia, Carlos Roncero, Lara Yuguero, Antoni Gual
BACKGROUND: Alcohol dependence remains a major health problem from both a public health and clinical perspective. Harm reduction strategies have been increasingly recognized as suitable treatment goals. Nalmefene has been recently approved for this precise therapeutic indication after completion of phase III trials. However, more data from routine practice settings are needed in order to obtain evidence with high external validity. The aim of this study was to conduct a single-arm, phase IV study with alcohol-dependent outpatients starting nalmefene for the first time...
October 27, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28940866/pharmacologically-controlled-drinking-in-the-treatment-of-alcohol-dependence-or-alcohol-use-disorders-a-systematic-review-with-direct-and-network-meta-analyses-on-nalmefene-naltrexone-acamprosate-baclofen-and-topiramate
#3
REVIEW
Clément Palpacuer, Renan Duprez, Alexandre Huneau, Clara Locher, Rémy Boussageon, Bruno Laviolle, Florian Naudet
BACKGROUND AND AIMS: Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders (AUDs) is an emerging concept. Our objective was to explore the comparative effectiveness of drugs used in this indication. DESIGN: Systematic review with direct and network meta-analysis of double-blind randomized controlled trials (RCTs) assessing the efficacy of nalmefene, naltrexone, acamprosate, baclofen or topiramate in non-abstinent adults diagnosed with alcohol dependence or AUDs...
September 20, 2017: Addiction
https://www.readbyqxmd.com/read/28919445/cognitive-effects-of-labeled-addictolytic-medications
#4
REVIEW
Camille Noélie Pujol, Cecilia Paasche, Vincent Laprevote, Benoit Trojak, Pierre Vidailhet, Elisabeth Bacon, Laurence Lalanne
INTRODUCTION: Alcohol, tobacco, and illegal drug usage is pervasive throughout the world, and abuse of these substances is a major contributor to the global disease burden. Many pharmacotherapies have been developed over the last 50years to target addictive disorders. While the efficacy of these pharmacotherapies is largely recognized, their cognitive impact is less known. However, all substance abuse disorders are known to promote cognitive disorders like executive dysfunction and memory impairment...
September 14, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28844812/antidepressant-like-effects-of-3-carboxamido-seco-nalmefene-3cs-nalmefene-a-novel-opioid-receptor-modulator-in-a-rat-ifn-%C3%AE-induced-depression-model
#5
Charlotte K Callaghan, Jennifer Rouine, Reginald L Dean, Brian I Knapp, Jean M Bidlack, Daniel R Deaver, Shane M O'Mara
Patients receiving the cytokine immunotherapy, interferon-alpha (IFN-α) frequently present with neuropsychiatric consequences and cognitive impairments. Patients (25-80%) report symptoms of depression, including, anhedonia, irritability, fatigue and impaired motivation. Our lab has previously demonstrated treatment (170,000IU/kg sc, 3 times per week for 4weeks) of the pro-inflammatory cytokine, IFN-α, induced a depressive phenotype in rats in the forced swim test (FST). Here, we examine the biological mechanisms underlying behavioral changes induced by IFN-α, which may be reflective of mechanisms underlying inflammation associated depression...
January 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28806388/naltrexone-or-nalmefene-related-buprenorphine-withdrawal-treat-it-with%C3%A2-more-buprenorphine
#6
Charles Lescut, Louise Gaboriau, Louise Carton, Benjamin Rolland
No abstract text is available yet for this article.
October 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28721822/opioid-antagonists-for-pharmacological-treatment-of-gambling-disorder-are-they-relevant
#7
Caroline Victorri-Vigneau, Andrew Spiers, Pascal Caillet, Mélanie Bruneau, Gaëlle Challet-Bouju, Marie Grall-Bronnec
Background: To date, no drugs have been approved for gambling disorder. Numerous publications have described the value of opioid antagonists. Indeed, the mesocorticolimbic dopaminergic pathway has been suggested as the underlying cause of reward-seeking behaviour, and it is modulated by the opioid system. Objective: This study aims to evaluate the relevance of opioid antagonists for treating GD. Method A systematic literature review was conducted. A search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database without any limits was performed...
July 18, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28658981/pharmacotherapy-of-alcoholism-an-update-on-approved-and-off-label-medications
#8
REVIEW
Michael Soyka, Christian A Müller
Only a few medications are available for the treatment of alcohol use disorders (AUDs). Areas covered: This paper discusses approved AUD medications, including the opioid antagonists naltrexone and nalmefene (the latter is licensed for reduction of alcohol consumption only), the putative glutamate receptor antagonist acamprosate and the aldehyde dehydrogenase inhibitor disulfiram. It also covers off-label medications of interest, including topiramate, gabapentin, ondansetron, varenicline, baclofen, sodium oxybate and antidepressants...
August 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28540656/nalmefene-in-alcohol-use-disorder-subjects-with-psychiatric-comorbidity-a-naturalistic-study
#9
Marco Di Nicola, Sergio De Filippis, Giovanni Martinotti, Luisa De Risio, Mauro Pettorruso, Simone De Persis, Angelo Giovanni Icro Maremmani, Icro Maremmani, Massimo di Giannantonio, Luigi Janiri
INTRODUCTION: Nalmefene is the first drug to be approved for reducing alcohol consumption in alcohol use disorder (AUD) patients at high drinking risk. In real-world settings, there is a high prevalence of concurrent psychiatric disorders in AUD subjects, with associated increased morbidity and worse prognosis. This study evaluated the use of nalmefene in AUD patients with stabilized psychiatric comorbidity previously treated unsuccessfully for alcohol dependence, and assessed craving reduction and safety...
May 24, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28493563/nalmefene-prevents-alcohol-induced-neuroinflammation-and-alcohol-drinking-preference-in-adolescent-female-mice-role-of-tlr4
#10
Jorge Montesinos, Anabel Gil, Consuelo Guerri
BACKGROUND: We previously showed that, by activating innate immune receptors Toll-like 4 (TLR4), adolescent intermittent ethanol (EtOH) exposure causes neuroinflammation, myelin damage, and behavioral dysfunctions. Recent findings reveal that clinically used opioid antagonists naltrexone (NT) and naloxone (NX) inhibit opioid-induced TLR4 signaling and that NT, NX, and nalmefene (NF), the 6-methylene derivative of NX, are able to reduce alcohol drinking escalation. METHODS: NF (0...
May 11, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28420033/the-current-clinical-knowledge-on-the-treatment-of-gambling-disorder-a-summary
#11
REVIEW
Karel Hloch, Přemysl Mladěnka, Martin Doseděl, Walter Adriani, Francesca Zoratto
Gambling disorder (GD) is a topical problem in developed countries and may be present in 1-3% of the general population. The pathophysiology of this disorder is largely unknown but it shares similarities to other behavioral addictions. Multiple neurotransmitter systems, including dopaminergic, serotonergic, noradrenergic, glutamatergic, and opioidergic, have been implicated in GD. Based on available articles, only the opioid antagonist naltrexone has been documented to demonstrate clinical efficacy in multiple studies including double-blind studies...
August 2017: Synapse
https://www.readbyqxmd.com/read/28406579/disparities-in-pharmacotherapy-for-alcohol-use-disorder-in-the-context-of-universal-health-care-a-swedish-register-study
#12
Katherine J Karriker-Jaffe, Jianguang Ji, Jan Sundquist, Kenneth S Kendler, Kristina Sundquist
BACKGROUND AND AIMS: Pharmacotherapy can be an important part of the continuum of care for alcohol use disorder (AUD). The Swedish universal health-care system emphasizes provision of care to marginalized groups. The primary aim was to test associations of neighborhood deprivation and disadvantaged social status with receipt of AUD pharmacotherapy in this context. DESIGN: Data from linked population registers were used to follow an open cohort over 7 years. SETTING: Sweden...
August 2017: Addiction
https://www.readbyqxmd.com/read/28376679/dopamine-and-%C3%AE-opioid-receptor-dysregulation-in-the-brains-of-binge-eating-female-rats-possible-relevance-in-the-psychopathology-and-treatment-of-binge-eating-disorder
#13
David J Heal, Michelle Hallam, Michael Prow, Jane Gosden, Sharon Cheetham, Yong K Choi, Frank Tarazi, Peter Hutson
Adult, female rats given irregular, limited access to chocolate develop binge-eating behaviour with normal bodyweight and compulsive/perseverative and impulsive behaviours similar to those in binge-eating disorder. We investigated whether (a) dysregulated central nervous system dopaminergic and opioidergic systems are part of the psychopathology of binge-eating and (b) these neurotransmitter systems may mediate the actions of drugs ameliorating binge-eating disorder psychopathology. Binge-eating produced a 39% reduction of striatal D1 receptors with 22% and 23% reductions in medial and lateral caudate putamen and a 22% increase of striatal μ-opioid receptors...
June 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28343423/management-of-precipitated-opiate-withdrawal-syndrome-induced-by-nalmefene-mistakenly-prescribed-in-opiate-dependent-patients-a-review-for-clinicians
#14
REVIEW
Nicolas Franchitto, Benedicte Jullian, Juliette Salles, Fanny Pelissier, Benjamin Rolland
Nalmefene, a long-acting µ-opioid antagonist approved to treat alcohol use disorder, is occasionally mistakenly prescribed to opiate-dependent or opioid-treated patients. We review recent literature on drug-drug interactions between nalmefene and opioids that lead to precipitated opioid withdrawal, and focus on its management and planning for care at discharge. Areas covered: This article provides a brief and comprehensive review of management of precipitated opioid withdrawal syndrome when nalmefene is associated with an opioid, whether misused or legally prescribed...
June 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28322465/opioid-substitution-therapy-or-hidden-opioids-are-a-minefield-for-nalmefene-an-atypical-case-series-of-11-patients-in-lorraine
#15
Melissa Yéléhé-Okouma, Hervé Martini, Jérémie Lemarié, Pierre Labroca, Nadine Petitpain, Valérie Gibaja, François Paille, Pierre Gillet
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption, is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment...
March 21, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28216062/nalmefene-reduces-reward-anticipation-in-alcohol-dependence-an-experimental-functional-magnetic-resonance-imaging-study
#16
Darren R Quelch, Inge Mick, John McGonigle, Anna C Ramos, Remy S A Flechais, Mark Bolstridge, Eugenii Rabiner, Matthew B Wall, Rexford D Newbould, Björn Steiniger-Brach, Franz van den Berg, Malcolm Boyce, Dorrit Østergaard Nilausen, Lasse Breuning Sluth, Didier Meulien, Christoph von der Goltz, David Nutt, Anne Lingford-Hughes
BACKGROUND: Nalmefene is a µ and δ opioid receptor antagonist, κ opioid receptor partial agonist that has recently been approved in Europe for treating alcohol dependence. It offers a treatment approach for alcohol-dependent individuals with "high-risk drinking levels" to reduce their alcohol consumption. However, the neurobiological mechanism underpinning its effects on alcohol consumption remains to be determined. Using a randomized, double-blind, placebo-controlled, within-subject crossover design we aimed to determine the effect of a single dose of nalmefene on striatal blood oxygen level-dependent (BOLD) signal change during anticipation of monetary reward using the monetary incentive delay task following alcohol challenge...
June 1, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/28205146/binge-drinking-current-diagnostic-and-therapeutic-issues
#17
Benjamin Rolland, Mickaël Naassila
The concept of binge drinking (BD) refers to patterns of heavy episodic alcohol consumption, with BD primarily occurring among adolescents and young adults. Several official definitions of BD have been proposed, in particular by the World Health Organization, the National Institute on Alcoholism and Alcohol Abuse, and the Substance Abuse and Mental Health Services Administration. Nevertheless, none of these definitions address the psychosocial and medical consequences of the type of alcohol use seen in BD. In practice, BD can thus correspond to either hazardous or harmful use of alcohol (HUA), while the episodic nature of heavy drinking in BD means that it does not meet the criteria for 'alcohol dependence'...
March 2017: CNS Drugs
https://www.readbyqxmd.com/read/28181957/use-of-nalmefene-in-patients-with-comorbid-borderline-personality-disorder-and-alcohol-use-disorder-a-preliminary-report
#18
Ana Martín-Blanco, Barbara Patrizi, Joaquim Soler, Xero Gasol, Matilde Elices, Miquel Gasol, Cristina Carmona, Juan C Pascual
Comorbidity between borderline personality disorder (BPD) and alcohol use disorder (AUD) is high and relevant as alcohol consumption seems to worsen BPD symptomatology. One of the newest treatments for AUD, nalmefene, may be useful to improve BPD symptoms not only indirectly by reducing alcohol consumption but also directly by acting on the opioid system as this system has been related to specific BPD symptoms. This open-label study aimed at evaluating the efficacy of an 8-week nalmefene treatment in reducing alcohol consumption in individuals with BPD and comorbid AUD...
July 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28019652/clinical-validation-of-reduced-alcohol-consumption-after-treatment-for-alcohol-dependence-using-the-world-health-organization-risk-drinking-levels
#19
Katie Witkiewitz, Kevin A Hallgren, Henry R Kranzler, Karl F Mann, Deborah S Hasin, Daniel E Falk, Raye Z Litten, Stephanie S O'Malley, Raymond F Anton
BACKGROUND: Alcohol use disorder (AUD) is a highly prevalent public health problem associated with considerable individual and societal costs. Abstinence from alcohol is the most widely accepted target of treatment for AUD, but it severely limits treatment options and could deter individuals who prefer to reduce their drinking from seeking treatment. Clinical validation of reduced alcohol consumption as the primary outcome of alcohol clinical trials is critical for expanding treatment options...
January 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27842940/nalmefene-for-the-management-of-alcohol-dependence-review-on-its-pharmacology-mechanism-of-action-and-meta-analysis-on-its-clinical-efficacy
#20
Karl Mann, Lars Torup, Per Sørensen, Antoni Gual, Robert Swift, Brendan Walker, Wim van den Brink
Nalmefene, a mu- and delta-opioid receptor (MOR, DOR) antagonist and a partial kappa-opioid receptor (KOR) agonist, is approved in the European Union and other countries for the reduction of alcohol consumption in alcohol dependent patients with a high drinking risk level according to WHO ("target population"). This review presents an overview of nalmefene׳s pharmacology, its mechanisms of action and a meta-analysis on its efficacy in reducing alcohol consumption. The review was based on a systematic search of the literature...
December 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
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