Extended-Release Injectable Naltrexone (XR-NTX) With Intensive Psychosocial Therapy for Amphetamine-Dependent Persons Seeking Treatment: A Placebo-Controlled Trial.
Extended-Release Injectable Naltrexone (XR-NTX) With Intensive Psychosocial Therapy for Amphetamine-Dependent Persons Seeking Treatment: A Placebo-Controlled Trial.
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DOI：
10.1097/adm.0000000000000297
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发表时间：
2017
影响因子：
5.5
通讯作者：
Woody GE
中科院分区：
文献类型：
--
作者：
Runarsdottir V;Hansdottir I;Tyrfingsson T;Einarsson M;Dugosh K;Royer-Malvestuto C;Pettinati H;Khalsa J;Woody GE
探索XR-NTX预防苯丙胺使用复发的有效性。在冰岛雷克雅未克进行的一项临床试验，100名寻求治疗的安非他明依赖患者在经过不同时间的住院治疗后进入强化门诊前随机接受6个月380 mg剂量的XR-NTX或匹配的安慰剂。每周尿药试验、尿潴留和标准化工具评估疗效。在169例患者中，100例被随机分组。虽然安非他明依赖是寻求治疗的主要原因，但四分之三或更多的参与者有一种或多种其他物质依赖。在51例随机分配至XR-NTX组的患者中，20例接受了4次或更多次注射;在49例分配至安慰剂组的患者中，26例接受了4次或更多次注射。在计划的2400次每周尿液药物检测中，收集了1247次（52%）;其中4%为安非他明阳性，8%为苯二氮卓类药物阳性，7%为大麻阳性，1%为可卡因阳性，1%为阿片类药物阳性。XR-NTX对安非他明阳性测试，保留或其他结果没有影响。那些提供一半或更多测试的人比那些提供不到一半测试的人参加了更多周的治疗（m = 10.76 vs. 3.31; t（92）= 5.91，p < .0001），92名参与者提供了至少一项测试。将XR-NTX添加到通常的住院和强化门诊治疗组合中并没有减少苯丙胺的使用。收集的尿样中物质使用的低流行率，以及收集的样本与治疗周数之间的相关性，与其他研究一致，表明继续治疗与更好的结果有关。
Explore the efficacy of XR-NTX for preventing relapse to amphetamine use. Clinical trial of 100 treatment-seeking patients with amphetamine dependence that were randomized to 6 monthly 380 mg doses of XR-NTX or matching placebo before entering intensive outpatient after varying lengths of inpatient treatment in Reykjavik, Iceland. Weekly urine drug tests, retention, and standardized instruments assessed efficacy. Of 169 approached, 100 were randomized. Though amphetamine dependence was the main reason for seeking treatment, three quarters or more of participants had one or more other substance dependencies. Of 51 randomized to XR-NTX, 20 received 4 or more injections; of 49 assigned to placebo, 26 received 4 or more injections. Of the planned 2400 weekly urine drug tests, 1247 were collected (52%); 4% of these were positive for amphetamine, 8% for benzodiazepine, 7% for marijuana, 1% for cocaine, and 1% for opioid. XR-NTX had no effect on amphetamine positive tests, retention, or other outcomes. Those providing half or more of their tests attended more weeks of treatment than those providing less than half of their tests (m = 10.76 vs. 3.31; t (92) = 5.91, p < .0001), and 92 participants provided at least one test. Adding XR-NTX to the usual combination of inpatient and intensive outpatient treatment did not reduce amphetamine use. The low prevalence of substance use among collected urine samples, and the association between collected samples and weeks in treatment, was consistent with other studies showing that staying in treatment is associated with better outcomes.