Document Detail


Intramuscular extended-release naltrexone: current evidence.
MedLine Citation:
PMID:  21272018     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extended-release naltrexone (XR-NTX; Vivitrol), developed to address poor adherence in addictive disorders, is approved for use in alcohol and opioid-dependence disorders. In alcohol-dependent adults with ≥ 4-day initial abstinence, XR-NTX increased initial and 6-month abstinence. An fMRI study found that XR-NTX attenuated the salience of alcohol visual and olfactory cues in the absence of alcohol, and post hoc analyses demonstrated efficacy even during high cue-exposure holiday periods. Safety and tolerability have generally been good, without adverse hepatic impact or intractable acute pain management. XR-NTX use appears feasible in primary care and public systems, and retrospective claims analyses have found cost savings and decreased intensive service utilization relative to oral agents. In opioid dependence, following detoxification, XR-NTX shows efficacy for maintaining abstinence, improving retention, decreasing craving, and preventing relapse. Trials are also exploring its use for the treatment of stimulant dependence. XR-NTX appears compatible with counseling and self-help attendance. While more research is needed, current findings suggest that a formulation of naltrexone that was sought beginning over three decades ago is fulfilling its promise as an extended-release pharmacotherapeutic.
Authors:
David R Gastfriend
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1216     ISSN:  1749-6632     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-06-21     Revised Date:  2011-06-23    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  144-66     Citation Subset:  IM    
Copyright Information:
© 2011 New York Academy of Sciences.
Affiliation:
Alkermes, Inc., Waltham, Massachusetts 02451-1420, USA. david.gastfriend@alkermes.com
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MeSH Terms
Descriptor/Qualifier:
Alcohol Drinking / prevention & control
Alcohol-Related Disorders / drug therapy*
Alcoholism / rehabilitation
Delayed-Action Preparations
Humans
Injections, Intramuscular
Naltrexone / administration & dosage*,  therapeutic use
Narcotic Antagonists / administration & dosage*,  therapeutic use
Opioid-Related Disorders / drug therapy*
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Narcotic Antagonists; 16590-41-3/Naltrexone
Comments/Corrections
Erratum In:
Ann N Y Acad Sci. 2011 Apr;1224(1):207

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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