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https://www.readbyqxmd.com/read/28527855/initiation-of-extended-release-naltrexone-xr-ntx-for-opioid-use-disorder-prior-to-release-from-prison
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28515558/a-rare-case-of-complicated-opioid-withdrawal-in-delirium-without-convulsions
#4
B Neeraj Raj, N Manamohan, Divya Hegde, Chandrashekar B Huded, Johnson Pradeep
Opioids are one of the commonly abused substances in India. Opioid withdrawal symptoms classically include severe muscle cramps, bone aches, autonomic symptoms, anxiety, restlessness, insomnia, and temperature dysregulation. However, reports of cases with delirium during withdrawal are few. A 25-year-old male with severe opioid withdrawal symptoms developed delirium. Investigations were normal. There were no comorbidities, no significant past history and family history. Patient treated for opioid dependence with tapering doses of lorazepam and clonidine...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28502630/new-opioid-receptor-antagonist-naltrexone-14-o-sulfate-synthesis-and-pharmacology
#5
Ferenc Zádor, Kornél Király, András Váradi, Mihály Balogh, Ágnes Fehér, Dóra Kocsis, Anna I Erdei, Erzsébet Lackó, Zoltán S Zádori, Sándor Hosztafi, Béla Noszál, Pál Riba, Sándor Benyhe, Susanna Fürst, Mahmoud Al-Khrasani
Opioid antagonists, naloxone and naltrexone have long been used in clinical practice and research. In addition to their low selectivity, they easily pass through the blood-brain barrier. Quaternization of the amine group in these molecules, (e.g. methylnaltrexone) results in negligible CNS penetration. In addition, zwitterionic compounds have been reported to have limited CNS access. The current study, for the first time gives report on the synthesis and the in vitro [competition binding, G-protein activation, isolated mouse vas deferens (MVD) and mouse colon assay] pharmacology of the zwitterionic compound, naltrexone-14-O-sulfate...
May 11, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28500210/first-line-medications-for-alcohol-use-disorders-among-public-drug-plan-beneficiaries-in-ontario
#6
Sheryl Spithoff, Suzanne Turner, Tara Gomes, Diana Martins, Samantha Singh
OBJECTIVE: To examine use of first-line alcohol use disorder (AUD) medications (naltrexone and acamprosate) among public drug plan beneficiaries in the year following an AUD diagnosis. DESIGN: Retrospective population-based cohort study. SETTING: Ontario. PARTICIPANTS: Individuals eligible for public drug plan benefits who had an AUD diagnosis at a hospital visit between April 1, 2011, and March 31, 2012. MAIN OUTCOME MEASURES: Number of AUD medications dispensed to public drug plan beneficiaries who had a recent hospital visit with an AUD diagnosis, and number of prescriptions dispensed per person...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28493563/nalmefene-prevents-alcohol-induced-neuroinflammation-and-alcohol-drinking-preference-in-adolescent-female-mice-role-of-tlr4
#7
Jorge Montesinos, Anabel Gil, Consuelo Guerri
BACKGROUND: We previously showed that, by activating innate immune receptors toll-like 4 (TLR4), adolescent intermittent ethanol 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/28481727/trends-in-opioid-use-disorder-diagnoses-and-medication-treatment-among-veterans-with-posttraumatic-stress-disorder
#8
Brian Shiner, Christine Leonard Westgate, Nancy C Bernardy, Paula P Schnurr, Bradley V Watts
OBJECTIVE: Despite long-standing interest in posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) comorbidity, there is a paucity of data on the prevalence of OUD in patients with PTSD. Therefore, there is limited understanding of the use of medications for OUD in this population. We determined the prevalence of diagnosed OUD and use of medications for OUD in a large cohort of patients with PTSD. METHODS: We obtained administrative and pharmacy data for Veterans who initiated PTSD treatment in the Department of Veterans Affairs (VA) between 2004 and 2013 (n = 731,520)...
May 8, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28481169/a-comparison-of-antidepressants-with-without-naltrexone-on-sexual-side-effects
#9
M Thapa, I Petrakis, E Ralevski
OBJECTIVE: The aim of the study was to compare the rate of sexual side effects of a serotonin reuptake inhibitor (SSRI) paroxetine versus tricyclic (TCI) desipramine and to examine the effect of co-prescription of naltrexone on sexual side effects among participants in a randomized clinical trial. METHODS: This was a secondary analysis (N = 88) of veterans who participated in a 12 week trial. All veterans were randomized into one of four treatment groups: a) desipramine/naltrexone, b) desipramine/placebo, c) paroxetine/naltrexone and d) paroxetine/placebo...
May 8, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28479011/extended-release-naltrexone-for-opioid-use-disorder-started-during-or-following-incarceration
#10
Thomas Lincoln, Benjamin D Johnson, Patrick McCarthy, Ellen Alexander
A western Massachusetts county jail began initiating extended-release naltrexone (XR-NTX) prior to release from incarceration and linking participants to community treatment providers upon release. Program barriers prevented the start of XR-NTX prior to release for a subset. METHODS: This report consists of the initial 67 jail releasees with opioid dependence, 47 who received XR-NTX before release, and 20 after release. Utility of the program was assessed by determining medication addiction treatment (MAT) retention rates at 4, 8, and 24 weeks...
April 6, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28476270/corrigendum-to-an-evaluation-of-hepatic-enzyme-elevations-among-hiv-infected-released-prisoners-enrolled-in-two-randomized-placebo-controlled-trials-of-extended-release-naltrexone-journal-of-substance-abuse-treatment-47-2014-35-40
#11
Panagiotis Vagenas, Angela Di Paola, Maua Herme, Thomas Lincoln, Daniel J Skiest, Frederick L Altice, Sandra A Springer
No abstract text is available yet for this article.
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28476269/barriers-to-and-facilitators-of-pharmacotherapy-for-alcohol-use-disorder-in-va-residential-treatment-programs
#12
Andrea K Finlay, Laura S Ellerbe, Jessie J Wong, Christine Timko, Anna D Rubinsky, Shalini Gupta, Thomas R Bowe, Jennifer L Burden, Alex H S Harris
Among US military veterans, alcohol use disorder (AUD) is prevalent and in severe cases patients need intensive AUD treatment beyond outpatient care. The Department of Veterans Affairs (VA) delivers intensive, highly structured addiction and psychosocial treatment through residential programs. Despite the evidence supporting pharmacotherapy among the effective treatments for AUD, receipt of these medications (e.g., naltrexone, acamprosate) among patients in residential treatment programs varies widely. In order to better understand this variation, the current study examined barriers and facilitators to use of pharmacotherapy for AUD among patients in VA residential treatment programs...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28473233/relapse-to-opioid-use-disorder-after-inpatient-treatment-protective-effect-of-injection-naltrexone
#13
Edward V Nunes, Michael Gordon, Peter D Friedmann, Marc J Fishman, Joshua D Lee, Donna T Chen, Mei Chen Hu, Tamara Y Boney, Donna Wilson, Charles P O'Brien
BACKGROUND: Opioid use disorder is often treated with short term hospitalization and medically supervised withdrawal from opioids followed by counseling alone without medication assisted treatment (MAT). More evidence is needed to confirm the expectation that the rate of relapse would be high after short term inpatient treatment and withdrawal from opioids without follow-up MAT. OBJECTIVE/METHODS: To examine relapse to opioid use disorder in a randomized, multi-site effectiveness trial of extended-release injection naltrexone (XR-NTX) vs community-based treatment as usual (TAU) without medication, as a function of the type of clinical service where treatment was initiated-short-term inpatient (N=59), long-term inpatient (N=48), or outpatient (N=201)...
April 23, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28462579/pharmacological-management-of-obesity
#14
Amanda Velazquez, Caroline M Apovian
Current management of obesity includes three main arms: behavioral modification, pharmacologic therapy, and bariatric surgery. Decades prior, the only pharmacological agents available to treat obesity were approved only for short-term use (≤ 12 weeks) by the Food and Drug Administration (FDA). However, in the last several years, the FDA has approved several medications for longer term treatment of obesity. This highlights the important progression that we, as a society, better appreciate now the chronicity and complexity of obesity as a disease...
April 28, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28449955/predictors-of-induction-onto-extended-release-naltrexone-among-unemployed-heroin-dependent-adults
#15
Brantley P Jarvis, August F Holtyn, Meredith S Berry, Shrinidhi Subramaniam, Annie Umbricht, Michael Fingerhood, George E Bigelow, Kenneth Silverman
BACKGROUND AND AIM: Extended-release naltrexone (XR-NTX) blocks the effects of opioids for 4weeks; however, starting treatment can be challenging because it requires 7 to 10days of abstinence from all opioids. In the present study we identified patient and treatment characteristics that were associated with successful induction onto XR-NTX. METHODS: 144 unemployed heroin-dependent adults who had recently undergone opioid detoxification completed self-report measures and behavioral tasks before starting an outpatient XR-NTX induction procedure...
April 20, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28440810/naltrexone-modulates-dopamine-release-following-chronic-but-not-acute-amphetamine-administration-a-translational-study
#16
N Jayaram-Lindström, J Guterstam, J Häggkvist, M Ericson, T Malmlöf, B Schilström, C Halldin, S Cervenka, T Saijo, A-L Nordström, J Franck
The opioid antagonist naltrexone has been shown to attenuate the subjective effects of amphetamine. However, the mechanisms behind this modulatory effect are currently unknown. We hypothesized that naltrexone would diminish the striatal dopamine release induced by amphetamine, which is considered an important mechanism behind many of its stimulant properties. We used positron emission tomography and the dopamine D2-receptor radioligand [(11)C]raclopride in healthy subjects to study the dopaminergic effects of an amphetamine injection after pretreatment with naltrexone or placebo...
April 25, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28421874/pharmacokinetics-safety-and-tolerability-of-a-novel-tocopheryl-phosphate-mixture-oxycodone-transdermal-patch-system-a-phase-i-study
#17
Paul D Gavin, Lee S Simon, Thomas Schlagheck, Alisha J Smith, Sepehr Shakib
AIM: To characterize the pharmacokinetic profile and evaluate the safety and tolerability of a transdermal oxycodone patch containing tocopheryl phosphate mixture (TPM). PATIENTS & METHODS: Eleven healthy subjects received a single application of three TPM/oxycodone patches applied to the torso for 72 h. RESULTS: Oxycodone was detected 8.0 ± 2.7-h postpatch administration, reaching a mean maximum plasma concentration of 3.41 ± 1.34 ng/ml at 49...
April 19, 2017: Pain Management
https://www.readbyqxmd.com/read/28421338/tailoring-pharmacotherapy-to-specific-eating-behaviours-in-obesity-can-recommendations-for-personalised-therapy-be-made-from-the-current-data
#18
Carl A Roberts, Paul Christiansen, Jason C G Halford
Pharmacotherapy provides an adjunct to behaviour modification in the management of obesity. There are a number of new drug therapies purportedly targeting appetite; liraglutide, and bupropion/naltrexone, which are European Medicines Agency and US Food and Drug Administration (FDA) approved, and lorcaserin and phentermine/topiramate, which have FDA approval only. Each of the six drugs, used singly or in combination, has distinct pharmacological, and presumably distinct behavioural, mechanisms of action, thus the potential to provide defined therapeutic options to personalise the management of obesity...
April 19, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28420033/the-current-clinical-knowledge-on-the-treatment-of-gambling-disorder-a-summary
#19
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...
April 18, 2017: Synapse
https://www.readbyqxmd.com/read/28410920/potential-drug-interaction-with-opioid-agonist-in-the-setting-of-chronic-low-dose-opioid-antagonist-use
#20
James B Leonard, Vidya Nair, Christopher J Diaz, Jonathan B Penoyar, Penelope A Goode
Low dose naltrexone (LDN) has been evaluated in several small studies for the treatment of inflammatory conditions. It is thought to work through modulation of inflammatory mediators and upregulation of endogenous opioid receptors. This may hypersensitize patients to exogenous opioids. Drug-drug interaction screening tools built into electronic health records and other services identify the interaction as risk of opioid withdrawal rather than hypersensitivity. We present a case of a drug-drug interaction in a patient who was receiving LDN treatment of multiple sclerosis...
April 6, 2017: American Journal of Emergency Medicine
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