Better response with four-week than two- or one-week regimen plus naltrexone maintenance
THURSDAY, Oct. 24 (HealthDay News) -- For prescription opioid (PO)-dependent outpatients, response is better with a four-week than a two- or one-week tapering regimen plus naltrexone hydrochloride therapy, according to a study published online Oct. 23 in JAMA Psychiatry.
Stacey C. Sigmon, Ph.D., from the University of Vermont in Burlington, and colleagues conducted a 12-week trial in an outpatient research clinic in which 70 PO-dependent adults underwent brief stabilization with a combination of buprenorphine hydrochloride and naloxone hydrochloride dihydrate, and were then randomized to receive one-, two-, or four-week tapering regimens followed by naltrexone therapy. Participants visited the clinic daily during phase 1 (weeks one to five after randomization), and three times per week during phase 2 (weeks six to 12 after randomization).
The researchers found that at the end of phase 1, opioid abstinence was significantly greater in the four-week condition than in the two-week or one-week conditions (63, 29, and 29 percent of participants abstinent, respectively). Abstinence was also significantly greater at the end of phase 2 in the four-week versus the two- and one-week conditions (50, 16, and 20 percent, respectively). There were significantly more treatment responders in the four-week condition (50, 17, and 21 percent, respectively).
"Results suggest that a meaningful subset of PO-dependent outpatients may respond positively to a four-week taper plus naltrexone maintenance intervention," the authors write.
One author disclosed financial ties to Titan Pharmaceuticals. The buprenorphine and matched placebo tables were provided by Reckitt Benckiser Pharmaceuticals.
Abstract (http://archpsyc.jamanetwork.com/article.aspx?articleid=1761270#Abstract )Full Text (subscription or payment may be required) (http://archpsyc.jamanetwork.com/article.aspx?articleid=1761270 )