Buprenorphine in opiate withdrawal: A comparison with clonidine

Comparative Trial to Study the Effectiveness of Clonidine Hydrochloride and Buprenorphine-Naloxone in Opioid Withdrawal – A Hospital Based Study

“…Most of the studies comparing the efficacy of the two drugs in controlling the opioid withdrawal have found buprenorphine to be superior over clonidine. Nigam et al, [12] and Ziaaddini et al, [20] in their studies revealed the fact that buprenorphine proved to be a better drug than clonidine in controlling opioid withdrawals. In the present study it was observed that buprenorphine was superior to clonidine in controlling the opioid withdrawal during the first few days of detoxification but after day 6 the COWS score was comparable in both the groups and the subjects were withdrawal free thereafter.…”

“…Treatment-seeking subjects in the age group of 15-50 years fulfilling American Psychiatric Association`s Diagnostic and Statistical Manual Disorders-1V (DSM-1V) criteria for opiate dependence, and agreeable to and capable of signing the written informed consent were admitted and included for this in-patient study [10]. Exclusion criteria included evidence of a serious psychiatric or medical illness, subjects reporting after 48 hours of last opiate use, those having any contraindication to the drugs to be given during the study period (buprenorphine-naloxone and clonidine) and patients using substances of abuse other than [11,12]. Psychiatric interview and medical history taking was performed by resident psychiatrist at the start of admission.…”

Clonidine versus Withdrawal Using an Opioid in In-Patient Opioid Detoxification

“…Although other controls have been employed in a few pre vious studies employing drugs like sedative-hypnotics, analgesics or major tranquilizers [12,17], these latter agents are not the drugs of proven efficacy [18]. Compar ing clonidine with withdrawal using an opioid thus helps us in drawing more valid inferences regarding the efficacy of clonidine as an anti-withdrawal agent [13,19].…”

“…In spite of this, empirical studies from India are few, one being a single case report [11], another comparing clonidine with sedative-hypnotics [12]. Only one recent study has compared clonidine with buprénorphine in opiate withdrawal [13], though the rationale there was different, buprénorphine having a mixed (agonist-antagonist) action on the opioid mu and kappa receptors [14]. The aim of this preliminary report is to explore the anti-withdrawal potential of clonidine in an inpatient sample of opioid-dependent patients, vis-à-vis that of morphine and meperidine as substitution agents.…”

Post-Treatment Outcomes of Buprenorphine Detoxification in Community Settings: A Systematic Review

“…More recently buprenorphine, a partial opiate agonist, has become a frequent choice. Of the aforementioned buprenorphine appears to have advantages as a withdrawal medication, showing some better results than methadone [3,15] , lofexidine [16] and clonidine [17] in a number of features, including reduced withdrawal symptoms and side effects, and higher completion of detoxification. Systematic reviews of opiate detoxification treatment to date [7,14,18] have concentrated primarily on the direct efficacy of the medications in question, the withdrawal profile during the process, adverse effects incurred and completion of the detoxification schedules, hence focusing on shorter-term outcomes.…”