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https://www.readbyqxmd.com/read/28640990/opiate-antagonists-do-not-interfere-with-the-clinical-benefits-of-stimulants-in-adhd-a-double-blind-placebo-controlled-trial-of-the-mixed-opioid-receptor-antagonist-naltrexone
#1
Thomas J Spencer, Pradeep Bhide, Jinmin Zhu, Stephen V Faraone, Maura Fitzgerald, Amy M Yule, Mai Uchida, Andrea E Spencer, Anna M Hall, Ariana J Koster, Joseph Biederman
OBJECTIVE: Methylphenidate activates μ-opioid receptors, which are linked to euphoria. μ-Opioid antagonists, such as naltrexone, may attenuate the euphoric effects of stimulants, thereby minimizing their abuse potential. This study assessed whether the combination of naltrexone with methylphenidate is well-tolerated while preserving the clinical benefits of stimulants in subjects with attention-deficit/hyperactivity disorder (ADHD). METHODS: We conducted a 6-week, double-blind, placebo-controlled, randomized clinical trial of naltrexone in adults with DSM-IV ADHD receiving open treatment with a long-acting formulation of methylphenidate from January 2013 to July 2015...
June 20, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28635181/buprenorphine-requires-concomitant-activation-of-nop-and-mop-receptors-to-reduce-cocaine-consumption
#2
Marsida Kallupi, Qianwei Shen, Giordano de Guglielmo, Dennis Yasuda, V Blair Journigan, Nurulain T Zaveri, Roberto Ciccocioppo
Buprenorphine's clinical use is approved for the treatment of heroin addiction; however, evidence supporting its efficacy in cocaine abuse also exists. While for heroin it has been demonstrated that the effect of buprenorphine is mediated by its ability to activate μ-opioid peptide receptor (MOP) receptors, the mechanism through which it attenuates cocaine intake remains elusive. We explored this mechanism using operant models where rodents were trained to chronically self-administer cocaine for 2 hours daily...
June 21, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28628701/trends-in-receipt-of-buprenorphine-and-naltrexone-for-opioid-use-disorder-among-adolescents-and-young-adults-2001-2014
#3
Scott E Hadland, J Frank Wharam, Mark A Schuster, Fang Zhang, Jeffrey H Samet, Marc R Larochelle
Importance: Opioid use disorder (OUD) frequently begins in adolescence and young adulthood. Intervening early with pharmacotherapy is recommended by major professional organizations. No prior national studies have examined the extent to which adolescents and young adults (collectively termed youth) with OUD receive pharmacotherapy. Objective: To identify time trends and disparities in receipt of buprenorphine and naltrexone among youth with OUD in the United States...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28626482/the-possible-mechanisms-of-analgesia-produced-by-microinjection-of-morphine-into-the-lateral-habenula-in-the-acute-model-of-trigeminal-pain-in-rats
#4
Emad Khalilzadeh, Gholamreza Vafaei Saiah
This study aimed to assess the effect of intra-habenular injection of morphine on acute trigeminal pain in rats. Also here, we examined the involvement of raphe nucleus opioid and 5HT3 receptors on the antinociceptive activity of intra habenular morphine to explore the possibility of existence of descending antinociceptive relay between the habenula and raphe nucleus. The numbers of eye wiping response elicited by applying a drop (40 μL) of NaCl (5 M) solution on the corneal surface were taken as an index of acute trigeminal nociception...
June 2017: Research in Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28609749/fatal-and-non-fatal-opioid-overdose-in-opioid-dependent-patients-treated-with-methadone-buprenorphine-or-implant-naltrexone
#5
Erin Kelty, Gary Hulse
BACKGROUND: Illicit opioid use is associated with high rates of fatal and non-fatal opioid overdose. This study aims to compare rates of fatal and serious but non-fatal opioid overdose in opioid dependent patients treated with methadone, buprenorphine or implant naltrexone, and to identify risk factors for fatal opioid overdose. METHODS: Opioid dependent patients treated with methadone (n=3515), buprenorphine (n=3250) or implant naltrexone (n=1461) in Western Australia for the first time between 2001 and 2010, were matched against state mortality and hospital data...
June 10, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28605827/predischarge-injectable-versus-oral-naltrexone-to-improve-postdischarge-treatment-engagement-among-hospitalized-veterans-with-alcohol-use-disorder-a-randomized-pilot-proof-of-concept-study
#6
Angela Christina Busch, Meenakshi Denduluri, Joseph Glass, Scott Hetzel, Shalu P Gugnani, Michele Gassman, Dean Krahn, Brienna Deyo, Randall Brown
BACKGROUND: Injectable naltrexone for alcohol use disorders (AUDs) has been efficacious in several studies. It has not been (i) compared head-to-head with oral naltrexone or (ii) examined in the hospital setting as an intervention that might facilitate treatment attendance after hospital discharge. METHODS: Fifty-four hospitalized veterans identified as having DSM-IV-TR alcohol dependence were randomized to receive (i) a 50 mg oral naltrexone plus a 30-day prescription or (ii) a 380 mg intramuscular naltrexone injection prior to discharge...
June 12, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28604472/perioperative-pain-management-of-a-patient-taking-naltrexone-hcl-bupropion-hcl-contrave-a-case-report
#7
Allen Ninh, Sang Kim, Andrew Goldberg
A 42-year-old obese woman (body mass index = 30.2 kg/m) presented for urgent anterior cervical diskectomy and fusion. She had been taking oral naltrexone-bupropion extended-release (Contrave, Orexigen Therapeutics Inc, La Jolla, CA) for the past 6 months and continued using it until 12 hours preoperatively. Despite discontinuation of this medication, and employing an intraoperative and postoperative multimodal analgesia strategy, immediate pain control was inadequately achieved. Patients taking opioid antagonists who present for surgery pose unique challenges to the anesthesiologist and require extensive preoperative interdisciplinary discussions and planning for pain control throughout the perioperative period...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28595525/obesity-induced-hypertension-new-insights
#8
Christina Antza, Stella Stabouli, Michalis Natsis, Ioannis Doundoulakis, Vasilios Kotsis
BACKGROUND: New insights on the relationship between weight loss and hypertension and the role of the newly approved anti-obesity drugs on hypertension will be discussed Methods: Weight loss is a major factor to reduce blood pressure when a patient with excess weight is advised from the health care provider to change his lifestyle. A healthy lifestyle with reduction in body weight, reduction in caloric intake, increased fruit and vegetables consumption and reduced salt intake concomitant with an increase in physical exercise can reduce body weight and hypertension in overweight and obese patients, but not all obese are able to reduce their blood pressure and lose weight without treatment and special dietary care...
June 7, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28591852/morbidity-and-mortality-in-opioid-dependent-patients-after-entering-an-opioid-pharmacotherapy-compared-with-a-cohort-of-non-dependent-controls
#9
Erin Kelty, Gary Hulse
Aims: To compare morbidity and mortality in opioid dependence patients following the commencement of treatment with the general population. Methods: Morbidity and mortality in all patients treated with methadone, buprenorphine or implant naltrexone for opioid dependence for the first time between 2001 and 2010 in Western Australia was compared to a cohort of age and gender matched controls using state health records. Results: Compared to community controls rates of all-cause mortality, hospital admissions and Emergency Department attendances are significantly elevated in opioid dependent persons following the commencement of their first treatment...
June 7, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28580486/the-role-of-endogenous-opioid-system-in-the-regulation-of-heart-tolerance-to-stress-induced-damage
#10
Yu B Lishmanov, S Yu Tsibul'nikov, N V Naryzhnaya, M V Korobov, L N Maslov
In Wistar rats, stress was modeled by 24-h immobilization in a supine posture and stress-induced damage to the heart was assessed by accumulation of (99m)Tc-pyrophosphate in the myocardium. The intensity of stress reaction was measured by serum levels of cortisol and insulin. Both stressinduced damage to the heart and intensity of stress reaction were examined under control conditions and in rats treated with opioid receptor antagonists naltrexone, methylnaltrexone bromide, MR2266, and ICI174.864. Activation of central μ-opioid receptors with endogenous opioids aggravated stress-induced cardiomyopathy, while stimulation of peripheral μ-opioid receptors produced a cardioprotective effect...
June 3, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28576389/healthcare-utilization-in-adults-with-opioid-dependence-receiving-extended-release-naltrexone-compared-to-treatment-as-usual
#11
William E Soares, Donna Wilson, Niels Rathlev, Joshua D Lee, Michael Gordon, Edward V Nunes, Charles P O'Brien, Peter D Friedmann
BACKGROUND: Opioid use disorders have reached epidemic proportions, with overdose now the leading cause of accidental death in the United States. Extended release naltrexone (XR-NTX) has emerged as a medication treatment that reduces opioid use and craving. However, the effect of XR-NTX therapy on acute healthcare utilization, including emergency department visits and inpatient hospitalizations, remains uncertain. The objective of the current study is to evaluate hospital-based healthcare resource utilization in adults involved in the criminal justice system with a history of opioid use disorder randomized to XR-NTX therapy compared with treatment as usual (TAU) during a 6-month treatment phase and 12months post-treatment follow up...
May 12, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28553701/opioid-antagonists-with-minimal-sedation-for-opioid-withdrawal
#12
REVIEW
Linda Gowing, Robert Ali, Jason M White
BACKGROUND: Managed withdrawal is a necessary step prior to drug-free treatment or as the endpoint of long-term substitution treatment. OBJECTIVES: To assess the effects of opioid antagonists plus minimal sedation for opioid withdrawal. Comparators were placebo as well as more established approaches to detoxification, such as tapered doses of methadone, adrenergic agonists, buprenorphine and symptomatic medications. SEARCH METHODS: We updated our searches of the following databases to December 2016: CENTRAL, MEDLINE, Embase, PsycINFO and Web of Science...
May 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28546740/new-developments-in-managing-opioid-addiction-impact-of-a-subdermal-buprenorphine-implant
#13
REVIEW
MariaLisa Itzoe, Michael Guarnieri
Opioid addiction to prescription and illicit drugs is a serious and growing problem. In the US alone, >2.4 million people suffer from opioid use disorder. Government and pharmaceutical agencies have begun to address this crisis with recently released and revised task forces and medication-assisted therapies (MAT). For decades, oral or intravenous (IV) MATs have helped patients in their recovery by administration of opioid agonists (methadone, buprenorphine, oxycodone), antagonists (naltrexone, naloxone), and combinations of the two (buprenorphine/naloxone)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28543191/methadone-buprenorphine-and-naltrexone-for-the-treatment-of-opioid-use-disorder-in-pregnant-women
#14
Tran H Tran, Brooke L Griffin, Rebecca H Stone, Kathleen M Vest, Timothy J Todd
Pregnant women with opioid use disorder can be treated with methadone, buprenorphine, or naltrexone to reduce opioid use and improve retention to treatment. In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants are also discussed...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28536981/a-retrospective-cohort-study-of-birth-outcomes-in-neonates-exposed-to-naltrexone-in-utero-a-comparison-with-methadone-buprenorphine-and-non-opioid-exposed-neonates
#15
Erin Kelty, Gary Hulse
BACKGROUND: Naltrexone may provide a suitable alternative to methadone and buprenorphine in the treatment of pregnant opioid-dependent women; however, little is known about its effects on neonatal morbidity and mortality. OBJECTIVE: The aim was to evaluate the health of neonates exposed to naltrexone in utero, and compare it with outcomes in neonates exposed to methadone or buprenorphine and a non-exposed control group. METHODS: Sequential cohorts of Western Australian (WA) opioid-dependent women treated with implant naltrexone, oral methadone or sublingual buprenorphine were identified via records from a drug and alcohol clinic (Subiaco, WA) for naltrexone and state prescribing records for methadone and buprenorphine...
May 23, 2017: Drugs
https://www.readbyqxmd.com/read/28536980/a-retrospective-cohort-study-of-obstetric-outcomes-in-opioid-dependent-women-treated-with-implant-naltrexone-oral-methadone-or-sublingual-buprenorphine-and-non-dependent-controls
#16
Erin Kelty, Gary Hulse
BACKGROUND: Opioid pharmacotherapies play an important role in the treatment of opioid-dependent women; however, very little is known about the safety of naltrexone in pregnant patients. OBJECTIVE: This study examined the obstetric health of opioid-dependent women who were treated with implant naltrexone during pregnancy, and compared them with women treated with methadone and/or buprenorphine and a cohort of non-opioid-dependent controls. METHODS: Women treated with implant naltrexone, oral methadone or sublingual buprenorphine between 2001 and 2010, along with a cohort of age-matched controls, were linked with records from midwives, hospital and emergency departments (EDs) and the death registry to identify pregnancy and health events that occurred during pregnancy and in the post-partum period...
May 23, 2017: Drugs
https://www.readbyqxmd.com/read/28536359/reduced-pro-inflammatory-cytokines-after-eight-weeks-of-low-dose-naltrexone-for-fibromyalgia
#17
Luke Parkitny, Jarred Younger
Fibromyalgia (FM) is a complex, multi-symptom condition that predominantly affects women. The majority of those affected are unlikely to gain significant symptomatic control from the few treatments that are approved for FM. In this 10-week, single-blind, crossover trial we tested the immune effects of eight weeks of oral administration of low-dose naltrexone (LDN). We enrolled eight women with an average age of 46 years, symptom severity of 62 out of 100, and symptom duration of 14 years. We found that LDN was associated with reduced plasma concentrations of interleukin (IL)-1β, IL-1Ra, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-15, IL-17A, IL-27, interferon (IFN)-α, transforming growth factor (TGF)-α, TGF-β, tumor necrosis factor (TNF)-α, and granulocyte-colony stimulating factor (G-CSF)...
April 18, 2017: Biomedicines
https://www.readbyqxmd.com/read/28527855/initiation-of-extended-release-naltrexone-xr-ntx-for-opioid-use-disorder-prior-to-release-from-prison
#18
Peter D Friedmann, Donna Wilson, Randall Hoskinson, Michael Poshkus, Jennifer G Clarke
BACKGROUND: Opioid use disorder is common in prison populations, and prison release is a high-risk time for relapse and overdose. Initiation of extended release injectable naltrexone (XR-NTX)) prior to prison release might decrease relapse among opioid-dependent persons. OBJECTIVE: This pilot study examined the feasibility and acceptability of XR-NTX injection prior to prison release among adult inmates with opioid use disorder, followed by six months of community XR-NTX treatment...
April 19, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28527854/barriers-to-initiation-of-extended-release-naltrexone-among-hiv-infected-adults-with-alcohol-use-disorders
#19
Hélène Chokron Garneau, Alexandra Venegas, Richard Rawson, Lara A Ray, Suzette Glasner
Alcohol consumption is a major risk factor for the acquisition of HIV/AIDS and is associated with greater disease burden and mortality among those who become HIV-infected. Of the extant pharmacological treatments for alcohol use disorders, naltrexone is recognized as one of the most efficacious, producing robust reductions in alcohol craving and use. Given that treatment with oral naltrexone has been limited by problems with adherence, which are particularly prevalent among individuals with multiple chronic, co-occurring conditions, long-acting formulations may be a promising approach for HIV-infected substance users...
May 11, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28526967/update-on-barriers-to-pharmacotherapy-for-opioid-use-disorders
#20
REVIEW
Anjalee Sharma, Sharon M Kelly, Shannon Gwin Mitchell, Jan Gryczynski, Kevin E O'Grady, Robert P Schwartz
PURPOSE OF REVIEW: The recent heroin and prescription opioid misuse epidemic has led to a sharp increase in the number of opioid overdose deaths in the USA. Notwithstanding the availability of three FDA-approved medications (methadone, buprenorphine, and naltrexone) to treat opioid use disorder, these medications are underutilized. This paper provides an update from the recent peer-reviewed literature on barriers to the use of these medications. FINDINGS: These barriers are interrelated and can be categorized as financial, regulatory, geographic, attitudinal, and logistic...
June 2017: Current Psychiatry Reports
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