Document Detail

Neuroendocrine and behavioural responses to opioid receptor-antagonist during heroin detoxification: relationship with personality traits.
MedLine Citation:
PMID:  12920386     Owner:  NLM     Status:  MEDLINE    
The present study investigated clinical, cardiovascular and neuroendocrine consequences of rapid opioid detoxification (ROD) in heroin-dependent individuals, affected, or not, by comorbid antisocial personality disorder (ASPD). Thirty-two patients underwent ROD and subsequent treatment with daily naltrexone: 3 days detoxification procedures were performed utilizing clonidine, baclofen, oxazepam and ketoprofene, without anaesthesia. Withdrawal symptoms, mood changes, cardiovascular indexes (heart rate, blood pressure), norepinephrine (NE), epinephrine (EPI), adrenocorticotropic hormone (ACTH) and cortisol (CORT) were evaluated during naloxone-naltrexone administration on the second day of detoxification treatment. The patients were divided into two groups following DSM-IV criteria for ASPD. Group A comprised 14 ASPD patients and group B comprised 18 patients without ASPD. Slight and transient withdrawal symptoms and mood changes were demonstrated on the second day in the whole sample of patients, in association with a significant, but moderate, elevation of heart rate, blood pressure, NE (two-fold), EPI (five-fold), ACTH (two-fold) and CORT (two-fold) plasma levels, in response to opioid receptor-antagonist administration. When evaluated separately in ASPD (group A) and non-ASPD patients (group B), significantly higher withdrawal symptoms and mood changes, heart rate, blood pressure, NE, ACTH and cortisol levels were observed in ASPD subjects. By contrast, no differences were found in EPI responses to naloxone-naltrexone administration between group A and B patients. The significant differences demonstrated in clinical and neuroendocrine responses to opioid receptor-antagonist administration, in relation to personality traits, could be due to reduced alpha-adrenergic receptor sensitivity, which was previously reported in ASPD, with a possible impairment of clonidine action. Our study suggests that a detailed diagnostic assessment before detoxification procedure may help to predict treatment outcome.
Gilberto Gerra; Simona Ceresini; Assunta Esposito; Amir Zaimovic; Gabriele Moi; Monica Bussandri; Maria A Raggi; Enzo Molina
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International clinical psychopharmacology     Volume:  18     ISSN:  0268-1315     ISO Abbreviation:  Int Clin Psychopharmacol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-15     Completed Date:  2003-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8609061     Medline TA:  Int Clin Psychopharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  261-9     Citation Subset:  IM    
Addiction Research Center of Parma, Via Spalato 2, 43100 Parma, Italy.
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MeSH Terms
Blood Pressure / drug effects
Epinephrine / blood
Heart Rate / drug effects
Heroin Dependence / drug therapy*,  psychology*
Hydrocortisone / blood
Naltrexone / adverse effects,  pharmacology,  therapeutic use*
Narcotic Antagonists / adverse effects,  pharmacology,  therapeutic use*
Neurosecretory Systems / drug effects
Norepinephrine / blood
Personality Disorders / psychology*
Substance Withdrawal Syndrome*
Treatment Outcome
Reg. No./Substance:
0/Narcotic Antagonists; 16590-41-3/Naltrexone; 50-23-7/Hydrocortisone; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

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