Clinical utility of rapid clonidine-naltrexone detoxification for opioid abusers.
Clinical utility of rapid clonidine-naltrexone detoxification for opioid abusers.
复制标题
可乐定-纳曲酮快速解毒对阿片类药物滥用者的临床实用性。
DOI：
10.1111/j.1360-0443.1988.tb02576.x
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Kleber,HD
中科院分区：
文献类型：
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作者：
Vining,E;Kosten,TR;Kleber,HD
盐酸克拉定（一种α‐2肾上腺素能激动剂）和盐酸纳曲酮（一种阿片类拮抗剂）联合使用，在门诊/天的情况下，提供了一种安全有效的治疗阿片类药物突然戒断的4或5天。通过纳洛酮刺激试验验证和量化阿片类药物依赖后，17名海洛因使用者中有14名（82%）成功戒除阿片类药物并达到纳曲酮维持水平。9名患者中有8名（89%）成功完成了为期4天的研究，在第1天开始纳曲酮治疗。在第2天的研究中，患者的峰值平均剂量为0.6 mg/天，在第1天和第2天的4天研究中，患者的峰值平均剂量为0.5 mg，盐酸克拉定治疗3至5天，减轻了纳曲酮的戒断诱导效应。两组均给予纳曲酮单早晨剂量，剂量从纳曲酮治疗第一天的12.5 mg迅速增加到第三天的SO mg。可乐定显著降低了两组患者的血压，但没有产生临床问题。本研究通过开发每日单剂量纳曲酮方案，提高了可乐定-纳曲酮组合的可用性，纳曲酮剂量通常适用于任何阿片类药物治疗机构。
Clonidine hydrochloride (an alpha‐2 adrenergic agonist) and naltrexone hydrochloride (an opioid antagonist), given in combination, provide a safe and effective treatment of abrupt opioid withdrawal over 4 or 5 days in an outpatient/day setting. Following a naloxone challenge test to verify and quantify opioid dependence, 14 of 17 (82%) heroin users successfully withdrew from opioids and attained maintenance levels of naltrexone. Eight of 9 (89%) successfully completed the 4‐day study in which naltrexone therapy was begun on day I. Three to 5 days of clonidine hydrochloride treatment with a peak mean dose of 0.6 mg/day on day 2 for the patients in the S‐day study, and 0.5 mg on days 1 and 2 for patients in the 4‐day study, attenuated the withdrawal inducing effects of naltrexone. Both groups received naltrexone in single morning doses which were rapidly increased from 12.5 mg on the first day of naltrexone therapy to SO mg on the third day. Clonidine significantly decreased blood pressure in both groups without producing clinical problems. This study has improved the availability of the clonidine‐naltrexone combination by developing a single dose per day naltrexone regimen with naltrexone doses generally available to any opioid treatment facility.