A double-blind, placebo-controlled trial of dextromethorphan combined with clonidine in the treatment of heroin withdrawal

Journal of Clinical Psychopharmacology

Volumn 34, Issue 4, 2014, Pages 508-512

  Lin, Shih Ku ^a,b   Pan, Chun Hung ^a   Chen, Chia Hui ^c  

^a TAIPEI CITY HOSPITAL   (Taiwan)

^b TAIPEI MEDICAL UNIVERSITY   (Taiwan)

^c TAIPEI MEDICAL UNIVERSITY   (Taiwan)

Author keywords

dextromethorphan; heroin; opioid; withdrawal

Indexed keywords

CLONIDINE; DEXTROMETHORPHAN; DIAMORPHINE; FEXOFENADINE; FLURAZEPAM; IBUPROFEN; LOPERAMIDE; LORAZEPAM; METOCLOPRAMIDE; NITRAZEPAM; PLACEBO; TRAZODONE;

ADULT; AGITATION; ARTICLE; BEDTIME DOSAGE; CLINICAL GLOBAL IMPRESSION SCALE; CONTROLLED STUDY; DETOXIFICATION; DIARRHEA; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; FEMALE; HEROIN DEPENDENCE; HEROIN WITHDRAWAL; HOSPITAL PATIENT; HUMAN; INSOMNIA; MAJOR CLINICAL STUDY; MALE; MUSCLE SPASM; MYALGIA; NAMED INVENTORIES, QUESTIONNAIRES AND RATING SCALES; NAUSEA AND VOMITING; OBJECTIVE OPIOID WITHDRAWAL SCALE; POST HOC ANALYSIS; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; WITHDRAWAL SYNDROME; DRUG COMBINATION; MIDDLE AGED; SUBSTANCE WITHDRAWAL SYNDROME; TREATMENT OUTCOME;

ADULT; CLONIDINE; DEXTROMETHORPHAN; DOUBLE-BLIND METHOD; DRUG THERAPY, COMBINATION; FEMALE; HEROIN DEPENDENCE; HUMANS; MALE; MIDDLE AGED; SUBSTANCE WITHDRAWAL SYNDROME; TREATMENT OUTCOME;

EID: 84903706782     PISSN: 02710749     EISSN: 1533712X     Source Type: Journal    
DOI: 10.1097/JCP.0000000000000144     Document Type: Article

References (32)

1. Kleber HD, Gold MS, Riordan CE. The use of clonidine in detoxification from opiates. Bull Narc. 1980;32:1-10. (Pubitemid 11223157)
2. Charney DS, Sternberg DE, Kleber HD, et al. The clinical use of clonidine in abrupt withdrawal from methadone. Effects on blood pressure and specific signs and symptoms. Arch Gen Psychiatry. 1981;38:1273-1277. (Pubitemid 12228634)
3. Bisaga A, Popik P. In search of a new pharmacological treatment for drug and alcohol addiction: N-methyl-D-aspartate (NMDA) antagonists. Drug Alcohol Depend. 2000;59:1-15. (Pubitemid 30116834)
4. Trujillo KA, Akil H. Excitatory amino acids and drugs of abuse: a role for N-methyl-D-aspartate receptors in drug tolerance, sensitization and physical dependence. Drug Alcohol Depend. 1995;38:139-154.
5. Trujillo KA, Akil H. Inhibition of opiate tolerance by non-competitive N-methyl-D-aspartate receptor antagonists. Brain Res. 1994;633: 178-188.
6. Herman BH, Vocci F, Bridge P. The effects of NMDA receptor antagonists and nitric oxide synthase inhibitors on opioid tolerance and withdrawal. Medication development issues for opiate addiction. Neuropsychopharmacology. 1995;13:269-293. (Pubitemid 26008848)
7. Schneider SM, Michelson EA, Boucek CD, et al. Dextromethorphan poisoning reversed by naloxone. Am J Emerg Med. 1991;9:237-238.
8. Bem JL, Peck R. Dextromethorphan. An overview of safety issues. Drug Saf. 1992;7:190-199.
9. Choi DW. Dextrorphan and dextromethorphan attenuate glutamate neurotoxicity. Brain Res. 1987;403:333-336. (Pubitemid 17019714)
10. Ferkany JW, Borosky SA, Clissold DB, et al. Dextromethorphan inhibits NMDA-induced convulsions. Eur J Pharmacol. 1988;151:151-154.
11. Fisher RS, Cysyk BJ, Lesser RP, et al. Dextromethorphan for treatment of complex partial seizures. Neurology. 1990;40:547-549. (Pubitemid 20117551)
12. Elliott K, Kest B, Man A, et al. N-methyl-D-aspartate (NMDA) receptors, mu and kappa opioid tolerance, and perspectives on new analgesic drug development. Neuropsychopharmacology. 1995;13: 347-356. (Pubitemid 26007690)
13. Popik P, Kozela E, Danysz W. Clinically available NMDA receptor antagonists memantine and dextromethorphan reverse existing tolerance to the antinociceptive effects of morphine in mice. Naunyn Schmiedebergs Arch Pharmacol. 2000;361:425-432. (Pubitemid 30148880)
14. Chia YY, Liu K, Chow LH, et al. The preoperative administration of intravenous dextromethorphan reduces postoperative morphine consumption. Anesth Analg. 1999;89:748-752. (Pubitemid 29409834)
15. Koyuncuoglu H, Saydam B. The treatment of heroin addicts with dextromethorphan: a double-blind comparison of dextromethorphan with chlorpromazine. Int J Clin Pharmacol Ther Toxicol. 1990;28: 147-152. (Pubitemid 20228199)
16. Rosen MI, McMahon TJ, Woods SW, et al. A pilot study of dextromethorphan in naloxone-precipitated opiate withdrawal. Eur J Pharmacol. 1996;307:251-257. (Pubitemid 26233365)
17. Bisaga A, Gianelli P, Popik P. Opiate withdrawal with dextromethorphan. Am J Psychiatry. 1997;154:584.
18. Akerele E, Bisaga A, Sullivan MA, et al. Dextromethorphan and quinidine combination for heroin detoxification. Am J Addict. 2008;17:176-180. (Pubitemid 351883179)
19. Lin SL, Chao PC, Yeh CC, et al. Oral slow release dextromethorphan premedication provides a pethidine spare effect on posthemorrhoidectomy pain management. Acta Anaesthesiol Taiwan. 2004;42:87-91.
20. Handelsman L, Cochrane KJ, Aronson MJ, et al. Two new rating scales for opiate withdrawal. Am J Drug Alcohol Abuse. 1987;13:293-308. (Pubitemid 17143298)
21. Cook CC, Scannell TD, Lipsedge MS. Another trial that failed. Lancet. 1988;1:524-525. (Pubitemid 18059695)
22. Siu A, Drachtman R. Dextromethorphan: a review of N-methyl-daspartate receptor antagonist in the management of pain. CNS Drug Rev. 2007;13:96-106. (Pubitemid 46697843)
23. Lim G,Wang S, Zeng Q, et al. Expression of spinal NMDA receptor and PKCgamma after chronic morphine is regulated by spinal glucocorticoid receptor. J Neurosci. 2005;25:11145-11154. (Pubitemid 43089559)
24. Rehni AK, Jaggi AS, Singh N. Opioid withdrawal syndrome: emerging concepts and novel therapeutic targets. CNS Neurol Disord Drug Targets. 2013;12:112-125.
25. Tokuyama S, Ho IK. Inhibitory effects of diltiazem, an L-type Ca2+ channel blocker, on naloxone-increased glutamate levels in the locus coeruleus of opioid-dependent rats. Brain Res. 1996;722:212-216.
26. Tao R, Ma Z, Auerbach SB. Alteration in regulation of serotonin release in rat dorsal raphe nucleus after prolonged exposure to morphine. J Pharmacol Exp Ther. 1998;286:481-488. (Pubitemid 28318024)
27. Werling LL, Keller A, Frank JG, et al. A comparison of the binding profiles of dextromethorphan, memantine, fluoxetine and amitriptyline: treatment of involuntary emotional expression disorder. Exp Neurol. 2007;207:248-257. (Pubitemid 47429659)
28. Musacchio JM. Computer-assisted modeling of multiple dextromethorphan and sigma binding sites in guinea pig brain. Eur J Pharmacol. 1991;206:261-269.
29. Werling LL, Lauterbach EC, Calef U. Dextromethorphan as a potential neuroprotective agent with unique mechanisms of action. Neurologist. 2007;13:272-293. (Pubitemid 47396313)
30. Lauterbach EC. An extension of hypotheses regarding rapid-acting, treatment-refractory, and conventional antidepressant activity of dextromethorphan and dextrorphan. Med Hypotheses. 2012;78: 693-702.
31. Garnock-Jones KP. Dextromethorphan/quinidine: in pseudobulbar affect. CNS Drugs. 2011;25:435-445.
32. Gish EC, Miller JL, Honey BL, et al. Lofexidine, an alpha 2-receptor agonist for opioid detoxification. Ann Pharmacother. 2010;44: 343-351.