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About - Naltrexone

By mouth: Helps prevent alcohol or drug abuse relapse.

Injection: Helps prevent alcohol or drug abuse relapse.

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Results: 1 to 20 of 69

Does effect size in naltrexone trials for alcohol dependence differ for single-site vs. multi-center studies?

This review assessed the impact of study site and year of publication in trials of naltrexone for alcohol dependence. The authors concluded that the smaller effect sizes in multicentre studies may reflect random error due to differences among sites. It was difficult to assess the evidence since the review methods were not reported and study quality was not evaluated. Therefore, it is unclear whether the conclusions are reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

A systematic review of the effectiveness of naltrexone in the maintenance treatment of opioid and alcohol dependence

The authors concluded that there is insufficient evidence to confirm or refute the effectiveness of naltrexone for treating opioid dependence, but there is evidence for its effectiveness in managing alcohol dependence. The effect of combining naltrexone with psychosocial interventions is unclear. Despite methodological limitations and inadequate reporting in the review, the data presented appear to support these conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

The efficacy of acamprosate and naltrexone in the treatment of alcohol dependence: a relative benefits analysis of randomized controlled trials

The authors concluded that in the treatment of alcohol dependence, both acamprosate and naltrexone modestly improve outcomes compared to placebo. There was insufficient evidence to determine which drug is superior or assess long-term efficacy. In view of poor reporting of review methods, lack of information about individual studies and failure to evaluate statistical heterogeneity, these conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Do manualized psychosocial interventions help reduce relapse among alcohol-dependent adults treated with naltrexone or placebo? A meta-analysis

BACKGROUND:  During the past decade, several novel medication treatments and psychosocial interventions have been tested. Overall, their impact on reducing alcohol use and preventing relapse has been modest. These outcomes have spurred researchers to investigate whether the addition of manualized psychosocial therapies with demonstrated efficacy to pharmacotherpy would have a synergistic effect.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Naltrexone (50 mg) plus psychotherapy in alcohol-dependent patients: a meta-analysis of randomized controlled trials

BACKGROUND: Alcoholism is a chronic and potentially fatal disease. One of the therapeutic options is pharmacotherapy with the opioid antagonist naltrexone in combination with psychotherapy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Efficacy of maintenance treatment with naltrexone for opioid dependence: a meta-analytical review

The authors concluded that naltrexone is an effective treatment, the efficacy of which is moderated by the retention of patients. They also concluded that contingency management is a promising method for increasing retention. Overall, despite some potential limitations, the authors' conclusions appear appropriate and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Efficacy and safety of naltrexone use in pediatric patients with autistic disorder

The authors concluded that naltrexone may benefit children with autistic disorder, particularly those with self-injurious behaviour, if other attempted therapies have failed. Given the small sample sizes and unknown quality of the included studies, the reliability of the results is unknown.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Acamprosate supports abstinence, Naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes

The authors concluded that abstinence rates were significant increased by both naltrexone and acamprosate, but only naltrexone was associated with a significant decease in the risk of relapse to heavy drinking in non-abstinent drinkers. Evidence appeared to support the authors? conclusions, but incomplete reporting of review methods and study quality made it difficult to assess their reliability.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Association of mu-opioid receptor (OPRM1) gene polymorphism with response to naltrexone in alcohol dependence: a systematic review and meta-analysis

Previous studies have suggested that the effect of naltrexone in patients with alcohol dependence may be moderated by genetic factors. In particular, the possession of the G allele of the A118G polymorphism of the µ-opioid receptor gene (OPRM1) has been associated with a better response to naltrexone, although controversial results have been reported. The aim of this paper is to combine previous findings by means of a systematic review and a meta-analysis. We retrieved studies on the relationship between A118G polymorphism in OPRM1 gene and response to treatment with naltrexone in patients with alcohol dependence by means of electronic database search. A meta-analysis was conducted using a random-effects model. Calculations of odds ratio (OR) and their confidence intervals (CI) and tests for heterogeneity of the results have been performed. Six previous studies have analyzed the role of A118G polymorphism in response to naltrexone for alcohol dependence. After meta-analysis, we found that naltrexone-treated patients carrying the G allele had lower relapse rates than those who were homozygous for the A allele (OR: 2.02, 95% CI 1.26-3.22; P = 0.003). There were no differences in abstinence rates. Our results support the fact that the G allele of A118G polymorphism of OPRM1 moderates the effect of naltrexone in patients with alcohol dependence. This genetic marker may therefore identify a subgroup of individuals more likely to respond to this treatment.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?

The authors concluded that naltrexone should be considered for patients who have a goal of reducing heavy drinking days whereas acamprosate was a better option for those who seek abstinence. Given the limitations of the evidence it is not possible to determine which treatment is most effective under what circumstances. The authors? conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review

AIMS: To ascertain the efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

A systematic review and meta-analysis of naltrexone implants for the treatment of opioid dependence

This largely well-conducted review concluded that evidence on safety, efficacy, and effectiveness of naltrexone implants for treatment of opioid dependence was limited in quantity and quality, and had little clinical use in settings where effective treatments were already available; more research was needed. The authors' conclusions reflect the evidence presented and seem reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Naltrexone and nalmefene for alcohol dependent patients

Alcohol dependence is a chronic disease, which can develop when alcohol is heavily used over longer periods of time. Alcohol affects various brain regions, including the opioid receptor system, which mediates euphoric and pleasurable effects of alcohol. By blocking alcohol effects at these receptors, the opioid antagonists naltrexone and nalmefene can reduce alcohol "liking" and "craving" and thus support alcohol dependent patients in cutting down their drinking. 50 studies with 7793 participants were included in the review, in most studies treatment was provided over a period of three months. The review shows that more patients who took naltrexone were able to reduce the amount and frequency of drinking than those who took an identical appearing, but inert substance (placebo). On average, one out of nine patients was helped by naltrexone. Naltrexone does not have serious side effects, but gastrointestinal symptoms like nausea, stomach pain and loss of appetite are common. Some patients also get tired from naltrexone. For injectable formulations of naltrexone, which can be advantageous for patients who have problems with taking their medication on schedule, and the second opioid antagonist nalmefene, the database is still too sparse to allow final conclusions. Nevertheless, the available studies indicate that these drugs might have comparable effects on drinking than oral naltrexone has. Naltrexone does not cause dependency and unlike disulfiram, another medicine that is sometimes used to treat alcohol dependence, it does not make patients feel sick if they drink alcohol while taking it.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Do opioid antagonists such as naltrexone help people to stop smoking?

Opioid antagonists are a type of drug which blunts the effects of narcotics such as heroin and morphine, and might help reduce nicotine addiction by blocking some of the rewarding effects of smoking. Our review identified eight trials of naltrexone, a long‐acting opioid antagonist. The trials included over 1200 smokers. Half the trials gave everyone nicotine replacement therapy and tested whether naltrexone had any additional benefit. Compared to a placebo, naltrexone did not increase the proportion of people who had stopped smoking, at the end of treatment, or at six months or more after treatment, either on its own or added to NRT. The available evidence does not suggest that opioid antagonists such as naltrexone assist smoking cessation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Oral naltrexone as maintenance treatment to prevent relapse in opioid addicts who have undergone detoxification

Opioid dependence is considered to be a lifelong, chronic relapsing disorder. Substantial therapeutic efforts are needed to keep people drug free. Methadone treatment plays a vital role in detoxification or maintenance programs but some individuals who are on methadone continue to use illicit drugs, commit crime and engage in behaviours that promote the spread of communicable diseases. Naltrexone is a long acting opioid antagonist that does not produce euphoria and is not addicting. It is used in accidental heroin overdose and for the treatment of people who have opioid dependence. Naltrexone is particularly suitable to prevent a relapse to opioid use after heroin detoxification for those for whom failure to comply with treatment has major consequences, for example health professionals, business executives and individuals under legal supervision. Medication compliance and retention rates with naltrexone treatment are however low.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Low dose naltrexone for treatment of active Crohn’s disease

Crohn’s disease is a chronic inflammatory condition of the gut, which can affect people anywhere from the mouth to anus. Specific hormones (proteins that transmit instructions in the body) that are known to be involved in pain response may be involved in the inflammation that underlies Crohn’s disease. Perhaps by giving patients a low dose of one of these proteins called naltrexone Crohn’s disease can be improved.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Oral naltrexone as a treatment for relapse prevention in formerly opioid-dependent drug users: a systematic review and economic evaluation

Naltrexone is an opiate antagonist that is licensed for use orally as adjunctive therapy in the treatment of detoxified formerly opioid-dependent individuals (after around 10 days of being opiate free). It is taken in a dose of 50 mg per day and blocks the pleasurable and euphoric effects of heroin and other opiates. It works to help former opioid-dependent individuals to stay off drugs through the knowledge that these drugs will produce no positive effects. It does not increase motivation to stay abstinent and thus if people choose not to take the dose daily it will not work.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Evaluation, Trials and Studies Coordinating Centre (UK).

Version: 2007

Closing the Quality Gap: Revisiting the State of the Science (Vol. 4: Medication Adherence Interventions: Comparative Effectiveness)

To assess the effectiveness of patient, provider, and systems interventions (Key Question [KQ] 1) or policy interventions (KQ 2) in improving medication adherence for an array of chronic health conditions. For interventions that are effective in improving adherence, we then assessed their effectiveness in improving health, health care utilization, and adverse events.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: September 2012
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Drug Class Review: Long-Acting Opioid Analgesics: Final Update 6 Report [Internet]

We compared the effectiveness and harms of long-acting opioids and of long-acting opioids compared with short-acting opioids in adults with chronic noncancer pain.

Drug Class Reviews - Oregon Health & Science University.

Version: July 2011
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Comparative Effectiveness of Smoking Cessation Treatments for Patients With Depression: A Systematic Review and Meta-analysis of the Evidence [Internet]

Smoking is disproportionately higher among persons with depression (45% versus 22%). Furthermore, smokers with depression may experience more challenges when trying to make and maintain a quit attempt, such as greater negative mood symptoms from withdrawal, higher nicotine dependence, and greater likelihood of relapse, than smokers without depression. Despite the complex relationship between tobacco use and depression, smokers with depression are motivated to quit smoking and should be offered cessation services. Several evidence-based smoking cessation treatments are effective for the general population of smokers. Yet the comparative effectiveness of these strategies in smokers with depression is uncertain. Also, it is uncertain if factors that may facilitate targeted interventions, such as depression status, gender, and treatment sequencing (i.e., concurrent versus sequential) for mood and smoking cessation, differentially impact the effectiveness of smoking cessation interventions.

Evidence-based Synthesis Program - Department of Veterans Affairs.

Version: November 2010
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