Gamma-hydroxybutyric acid versus naltrexone in maintaining alcohol abstinence: an open randomized comparative study

Caputo, Fabio; Addolorato, Giovanni; Lorenzini, Francesca; Domenicali, Marco; Greco, Giovanni; Re, Arfedele Del; Gasbarrini, Giovanni; Stefanini, Giuseppe Francesco; Bernardi, Mauro

doi:10.1016/s0376-8716(02)00340-x

Cited by 68 publications

(33 citation statements)

References 40 publications

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“…Sixty percent completed the protocol, with 11.4% showing complete abstinence, 14.3% showing strongly reduced alcohol intake, and 34.3% still under treatment after a year (Maremmani, Lamanna, and Tagliamonte, 2001). Caputo et al (2003) evaluated the efficacy of GHB as compared to naltrexone in maintaining abstinence from alcohol after 3 months of treatment and found that in patients who failed to be abstinent, no relapses in heavy drinking were observed in the naltrexone group, while in the GHB group, all patients relapsed. The study found GHB was more effective than naltrexone in maintaining abstinence from alcohol in a short-term treatment period, but naltrexone confirmed its ability to reduce alcohol relapses.…”

Section: Cognitive/psychiatric Associationsmentioning

confidence: 97%

Party Drugs: Properties, Prevalence, Patterns, and Problems

Maxwell

2005

Substance Use & Misuse

114

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This review summarizes the latest literature on "party" or "club" drugs, defined as MDMA, GHB, ketamine, and Rohypnol, as published from 2002 to early 2005. Club drugs have been categorized as being used at raves and dance parties. The literature shows that each drug has different properties, users, and settings. Each drug has different adverse effects and requires different acute care protocols. Although these drugs were identified early, scientific information about them, including the toxicological tests to identify them, is still evolving. Increasing numbers of studies on the short- and long-term effects of these drugs on humans are being published, but because of limitations on research using human subjects, they may not always be as rigorous as desired and can be cited by drug users to discredit findings of harm. The lack of research-based information on these drugs has led to the emergence of web sites that may or may not provide accurate data. Evaluated chemical dependency treatment protocols using the latest research for each of these different drugs are needed.

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Section: Cognitive/psychiatric Associationsmentioning

confidence: 97%

Party Drugs: Properties, Prevalence, Patterns, and Problems

Maxwell

2005

Substance Use & Misuse

114

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“…[1][2][3] Because of this biologic property, GBH is currently used to induce and maintain abstinence from alcohol. [4][5][6] However, cases of craving and desire to increase doses of GHB have been reported. This has occurred with nonclinical self-administration, in a single dose ranging from 2.5 to 30 g per day, 5,7,8 and in 10%-15% of patients with alcohol or psychoactive substance dependence treated with 50 mg/kg of body weight divided into 3 daily doses.…”

mentioning

confidence: 97%

Suppression of Craving for γ-Hydroxybutyric Acid by Naltrexone Administration

Caputo

Vignoli²,

Lorenzini³

et al. 2005

Clinical Neuropharmacology

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Gamma-hydroxybutyric acid (GHB) is currently used to induce and maintain abstinence from alcohol. Cases of craving and desire to increase doses of GHB have been reported in both clinical trials and nonclinical self-administration. The enhancement of dopamine activity induced by GHB receptor activation might play a role in the euphoric effect and potential craving and the consequent abuse of this drug. Naltrexone (NTX), a mu-opioid antagonist, is effective in inducing and maintaining abstinence from alcohol, reducing relapses in heavy drinking and craving for alcohol in alcohol-dependent outpatients. Taking into account the alcohol antireward property of NTX, we tested its activity in reducing craving for GHB in 3 consecutive cases of alcoholics who manifested craving for this drug. In all patients the combination with NTX suppressed the craving for GHB. The antireward effect of NTX likely results from its interference with the GHB-induced dopamine release, leading to a partial blockade of the GHB reinforcing effect responsible of the craving for the drug. A combined therapy with GHB and NTX seems to be able to suppress craving for the former, thus improving the manageability and safety of treatment.

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“…GHB has anxiolytic, hypnotic, and anesthetic effects (Bernasconi et al, 1999) and can induce amnesia, sedation, absence seizures, and, at very large doses, coma and death (Roth and Suhr, 1970;Snead and Liu, 1993). GHB is approved for the treatment of narcolepsy and has been evaluated for treating alcohol and opioid dependence and withdrawal (Mason and Kerns, 2002;Caputo et al, 2003). The mechanism of action of GHB is not fully understood, although it is becoming clear that activity at more than one receptor contributes to its effects in vivo.…”

mentioning

confidence: 99%

The Discriminative Stimulus Effects of γ-Hydroxybutyrate and Related Compounds in Rats Discriminating Baclofen or Diazepam: The Role of GABA_B and GABA_A Receptors

Carter

Unzeitig

et al. 2004

J Pharmacol Exp Ther

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The discriminative stimulus effects of ␥-hydroxybutyrate (GHB) can be mimicked by GABA A receptor-positive modulators (e.g., diazepam) and GABA B receptor agonists (e.g., baclofen). The purposes of this study were to see whether stimulus control could be established with baclofen and to further characterize the role of GABAergic mechanisms in the behavioral actions of GHB by evaluating GHB and related compounds in rats discriminating either diazepam or baclofen. Training criteria were satisfied with baclofen and diazepam after 69 and 44 sessions, respectively. GHB and its precursors ␥-butyrolactone and 1,4-butanediol occasioned Ͼ80% responding on the drug-associated lever in rats discriminating baclofen and Ͻ11% in rats discriminating diazepam. Diazepam and other GABA A receptor-positive modulators occasioned intermediate levels of responding on the baclofen lever, whereas baclofen occasioned less than 4% responding on the diazepam lever. The GABA B receptor antagonist CGP 35348 [(3-aminopropyl)(diethoxymethyl) phosphinic acid] partially antagonized the effects of baclofen as well as the baclofen-like effects of GHB, and flumazenil partially antagonized the effects of diazepam. This study established stimulus control with baclofen, and substitution data provided direct evidence for a role of GABAergic, especially GABA B , mechanisms in the discriminative stimulus effects of GHB. The lack of substitution by GHB or its metabolic precursors for diazepam indicates a comparatively smaller role of GABA A mechanisms in these effects of GHB. The inability of CGP 35348 to completely attenuate the effects of baclofen and GHB suggests that multiple receptors could be involved in the discriminative stimulus effects of GHB.

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Gamma-hydroxybutyric acid versus naltrexone in maintaining alcohol abstinence: an open randomized comparative study

Cited by 68 publications

References 40 publications

Party Drugs: Properties, Prevalence, Patterns, and Problems

Party Drugs: Properties, Prevalence, Patterns, and Problems

Suppression of Craving for γ-Hydroxybutyric Acid by Naltrexone Administration

The Discriminative Stimulus Effects of γ-Hydroxybutyrate and Related Compounds in Rats Discriminating Baclofen or Diazepam: The Role of GABA_B and GABA_A Receptors

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Gamma-hydroxybutyric acid versus naltrexone in maintaining alcohol abstinence: an open randomized comparative study

Cited by 68 publications

References 40 publications

Party Drugs: Properties, Prevalence, Patterns, and Problems

Party Drugs: Properties, Prevalence, Patterns, and Problems

Suppression of Craving for γ-Hydroxybutyric Acid by Naltrexone Administration

The Discriminative Stimulus Effects of γ-Hydroxybutyrate and Related Compounds in Rats Discriminating Baclofen or Diazepam: The Role of GABAB and GABAA Receptors

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The Discriminative Stimulus Effects of γ-Hydroxybutyrate and Related Compounds in Rats Discriminating Baclofen or Diazepam: The Role of GABA_B and GABA_A Receptors