Efficacy of Buspirone in the Treatment of Opioid Withdrawal

Buydens‐Branchey, Laure; Branchey, Marc; Reel-Brander, Christine

doi:10.1097/01.jcp.0000162804.38829.97

Cited by 24 publications

(11 citation statements)

References 22 publications

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“…The effects observed with VLNTX add‐on were not associated with an increased proportion of patients completing detoxification. It is a rather common finding that a more comfortable detoxification is insufficient to encourage retention in treatment (Buydens‐Branchey, Branchey & Reel‐Brander 2005; Herman et al . 2005; Oreskovich et al .…”

Section: Discussionmentioning

confidence: 99%

CLINICAL STUDY: Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial

et al. 2009

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Although current treatments for opioid detoxification are not always effective, medical detoxification remains a required step before long-term interventions. The use of opioid antagonist medications to improve detoxification has produced inconsistent results. Very low dose naltrexone (VLNTX) was recently found to reduce opioid tolerance and dependence in animal and clinical studies. We decided to evaluate safety and efficacy of VLNTX adjunct to methadone in reducing withdrawal during detoxification. In a multi-center, double-blind, randomized study at community treatment programs, where most detoxifications are performed, 174 opioid-dependent subjects received NTX 0.125 mg, 0.250 mg or placebo daily for 6 days, together with methadone in tapering doses. VLNTX-treated individuals reported attenuated withdrawal symptoms [F = 7.24 (2,170); P = 0.001] and reduced craving [F = 3.73 (2,107); P = 0.03]. Treatment effects were more pronounced at discharge and were not accompanied by a significantly higher retention rate. There were no group differences in use of adjuvant medications and no treatment-related adverse events. Further studies should explore the use of VLNTX, combined with full and partial opioid agonist medications, in detoxification and longterm treatment of opioid dependence.

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Section: Discussionmentioning

confidence: 99%

CLINICAL STUDY: Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial

et al. 2009

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“…Buspirone may be a useful detoxification treatment by itself, as Buydens‐Branchey et al . found 30 mg and 45 mg daily was as effective for managing withdrawal symptoms as tapered methadone.…”

Section: Detoxification From Opioidsmentioning

confidence: 93%

Pharmacological strategies for detoxification

Diaper

Law

Melichar

2014

Brit J Clinical Pharma

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Detoxification refers to the safe discontinuation from a substance of dependence and is distinct from relapse prevention. Detoxification usually takes between a few days and a few weeks to complete, depending on the substance being misused, the severity of dependence and the support available to the user. Psychosocial therapies alongside pharmacological treatments are essential to improve outcome. The dependencies considered in this overview are detoxification from opioids (with methadone, buprenorphine, α2‐adrenoceptor agonists and adjunct medications), alcohol (with benzodiazepines, anti‐glutamatergics and γ‐aminobutyric acid (GABA)‐ergic drugs), stimulants and cannabis (with no clear recommended pharmacological treatments), benzodiazepines (with dose tapering) and nicotine (with nicotine replacement therapy, antidepressants and partial agonists). Evidence is limited by a lack of controlled trials robust enough for review bodies, and more research is required into optimal treatment doses and regimes, alone and in combination.

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“…Another approach is to use buspirone in the treatment of acute opioid withdrawal, the assumption being that a decrease in serotonergic neurotransmission may be involved in opioid withdrawal symptoms. Initial results found buspirone to be as effective as methadone tapering in alleviating withdrawal symptoms (52). However, more studies are necessary before firm conclusions can be drawn regarding the efficacy of these new detoxification strategies.…”

Section: Detoxificationmentioning

confidence: 99%

Evidence-Based Treatment of Opioid-Dependent Patients

2006

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Objective:To provide an overview of treatment options for opioid-dependent patients. Method:We screened all published studies on the treatment of opioid dependence, with a special focus on systematic literature reviews, formal metaanalyses, and recent trials. Results:Both clinical experience and neurobiological evidence indicate that opioid dependence is a chronic relapsing disorder. Treatment objectives depend on the pursued goals: crisis intervention, abstinence-oriented treatment (detoxification and relapse prevention), or agonist maintenance treatment. The high quality of solid evidence in the literature demonstrates that there are numerous effective interventions available for the treatment of opioid dependence. Crisis intervention, frequently necessary owing to the high overdose rate, can be effectively handled with naloxone. Abstinence-oriented interventions are effective for only a few motivated patients with stable living conditions and adequate social support. Agonist maintenance treatment is considered the first line of treatment for opioid dependence. Numerous studies have shown efficacy for methadone and buprenorphine treatment, while maintenance with other agonists is also becoming available to a greater extent. Maintenance treatment with diamorphine should be made available for the small group of treatment-resistant, severely dependent addicts. Other harm-reduction measures can serve to engage individuals with opioid addiction who are not in treatment. Conclusion:Opioid dependence is a chronic relapsing disease that is difficult to cure, but effective treatments are available to stabilize patients and reduce harm, thereby increasing life expectancy and quality of life. (Can J Psychiatry 2006;51:635-646) Information on funding and support and author affiliations appears at the end of the article. Clinical Implications· Agonist maintenance treatment plus psychosocial support should be widely available and freely accessible for all opioid-dependent individuals. · New extended release antagonist maintenance treatments are promising but should be reserved for internally motivated and stabilized opioid-dependent patients. · Prison sentences should be regarded as windows of opportunity for the start or continuation of maintenance treatment and psychosocial rehabilitation. Limitations· The literature is based on patients with heroin dependence, whereas in many places, heroin has been replaced as the drug of abuse by illicit prescription opioids. · New interventions such as heroin-assisted treatment, SROM, and extended release naltrexone have not be studied extensively. · Many prison-based interventions and harm-reduction measures used with opioid-dependent individuals not seeking treatment have not been tested in RCTs.

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Efficacy of Buspirone in the Treatment of Opioid Withdrawal

Cited by 24 publications

References 22 publications

CLINICAL STUDY: Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial

CLINICAL STUDY: Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial

Pharmacological strategies for detoxification

Evidence-Based Treatment of Opioid-Dependent Patients

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