Florid opioid withdrawal–like reaction precipitated by naltrexone in a patient with chronic cholestasis

Jones, E. Anthony; Dekker, Lrc Lukas

doi:10.1016/s0016-5085(00)70225-3

Cited by 69 publications

(29 citation statements)

References 5 publications

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“…[88,89] Opioid dependence Yes (Adult) Available data suggest that naltrexone is an effective and safe narcotic antagonist for the treatment of narcotic addiction. Pruritus of skin No Efficacy in uremia-associated pruritus controversial Effective for pruritus caused by other etiologies such as dermatological diseases, liver cirrhosis, or diabetes [124][125][126][127][128] Self-injurious behavior No Effective in treating self-injurious behaviors in autistic and mentally retarded patients Reduces dissociation symptoms and flashbacks in borderline personality disorder [129][130][131][132][133] www.chemmedchem.org lation of naltrexone, Vivitrol. [38] Administered intramuscularly, this once-a-month treatment was recently approved by the FDA for the treatment of alcohol addiction.…”

Section: Nomentioning

confidence: 99%

Mu Opioid Receptor Antagonists: Recent Developments

2007

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For thousands of years mu opioid agonists such as morphine have been utilized for their analgesic properties. Today, morphine and related compounds are still used as a first line therapy in the treatment of moderate to severe pain. However, despite the clear benefits of mu agonists in pain management, severe side effects such as dependence and respiratory depression are associated with use of these drugs. To date, there are only two approved mu opioid antagonists for use in the treatment of these adverse effects, that is, naloxone and naltrexone. However, many other clinical and therapeutic areas have been linked to mu opioid receptor antagonism. These include treatment of opioid induced pruritis of the skin, obesity, and Parkinson‐induced tardive dyskinesia. Currently there are two compounds, N‐methylnaltrexone and alvimopan, under FDA review as possible treatments for opioid induced bowel dysfunction and postoperative ileus. These compounds are of special interest as they are peripherally restricted. This attribute enables treatment of peripheral side effects induced by opioid agonists without reversal of the centrally mediated analgesia of the agonist. In this article we discuss the structural classes of mu opioid antagonists, their potential clinical applications, and review the relevant patents of the last ten years.

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Section: Nomentioning

confidence: 99%

Mu Opioid Receptor Antagonists: Recent Developments

2007

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“…[6][7][8] In addition, plasma from patients who have pruritus associated with chronic cholestasis induced opioid receptoremediated scratching in monkeys, 9 and naltrexone treatment of this pruritus in humans precipitated an opioid withdrawallike reaction. 10 These observations suggest a crucial role of the opioid receptor system and its ligands, such as b-endorphin, in chronic cholestatic pruritus. Systemically applied naltrexone reduced itching not only in patients with hepatogenic pruritus, but also in those with different pruritic skin diseases, such as atopic dermatitis, xerosis cutis, cutaneous lymphoma, and prurigo nodularis.…”

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confidence: 98%

Treatment of pruritus with topically applied opiate receptor antagonist

Bigliardi¹,

Stammer²,

Jost³

et al. 2007

Journal of the American Academy of Dermatology

110

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“…All MORA are usually well tolerated with dose-dependent side effects generally limited to the first 2 weeks of treatment. 15,[18][19][20][21][22][23][24][25][26][27] Interestingly, female and younger subjects are more likely to report nausea. 28 Rarely, opioid withdrawal reactions such as severe lightheadedness, disturbed body image, depersonalization, anxiety, paresthesias, and hallucinations have been reported to occur.…”

Section: Side Effectsmentioning

confidence: 99%