Naltrexone in the treatment of heroin dependence: relationship with depression and risk of overdose.
Objective: This article examines the use of naltrexone in the treatment of heroin dependence. The relationship between naltrexone and depression as well as risk of overdose is examined. Method: The existing literature is reviewed along with recent interim data from clinical trials underway in Victor...
| Publicado en: | Australian & New Zealand Journal of Psychiatry Vol. 36; no. 2; pp. 224 - 229 |
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| Autor principal: | |
| Formato: | Journal Article |
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Sage Publications Inc.
Apr2002
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106097211&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106097211 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Apr2002 vid: 36 iid: 2 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 106097211 106097211 2009448140 10.1046/j.1440-1614.2002.01012.x NLM11982544 106097211 ppf: 224 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Naltrexone in the treatment of heroin dependence: relationship with depression and risk of overdose. aug: au: Ritter AJ sug: subj: Depression Complications Naltrexone Adverse Effects Naltrexone Therapeutic Use Narcotic Antagonists Adverse Effects Narcotic Antagonists Therapeutic Use Overdose Etiology Substance Use Disorders Drug Therapy Risk Factors Substance Use Disorders Complications ab: Objective: This article examines the use of naltrexone in the treatment of heroin dependence. The relationship between naltrexone and depression as well as risk of overdose is examined. Method: The existing literature is reviewed along with recent interim data from clinical trials underway in Victoria. Results: Naltrexone is a recent addition to treatment for heroin dependence in Australia. The relationship between depression and naltrexone has been examined in previous literature. Underlying rates of depression in heroin users are high and treatment may resolve or exacerbate depression. Research to date demonstrates that the addition of naltrexone does not necessarily increase depression in patients. The risk of non-fatal heroin overdose is significantly elevated after naltrexone treatment as a result of reduced tolerance. Data from clinical trials underway in Victoria demonstrate a significantly elevated rate of non-fatal overdose in naltrexone patients compared to those in substitution maintenance treatment. The mortality rate subsequent to naltrexone treatment appears to be equivalent to or greater than that for untreated heroin users. Further research is required. Conclusions: Clinicians need to carefully monitor depression in patients, and warn patients of the risks of reduced tolerance to opiates following naltrexone treatment. Agonist treatments such as methadone, LAAM and buprenorphine carry much less risk of overdose. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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