α₂-Receptor Agonists for Treatment and Prevention of Iatrogenic Opioid Abstinence Syndrome in Critically Ill Patients

Abstract

Central alpha(2)-agonists appear to be effective and safe second-line agents for treatment and prevention of IOAS. Further studies should be conducted to determine their role in the therapy of patients with IOAS.

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Substance Use and Related Disorders. Part 2: Opioid dependence

“…Clonidine is an alternative to methadone, but the completion rate for outpatients is relatively modest . The use of a transdermal clonidine patch (Honey et al 2009) could improve adherence. In contrast to earlier guidelines in which alpha-2-adrenergic agonists were considered preferable to methadone for brief treatment (Lingford-Hughes et al 2004), more recent guidelines do not recommend routine use of the drug for opioid detoxi fi cation (NICE 2007).…”

The Anesthetic Implications of Opioid Addiction

“…Side effects include sedation, dry mouth, orthostatic hypotension, and constipation. Other alpha2-receptor agonists, such as dexmedetomidine, have been used for treating withdrawal symptoms [74][75][76] . Other medications that can help with withdrawal symptoms include nonopioid analgesics, anxiolytics (Librium), sleeping pills (temazepam, diphenhydramine), antiemetics (promethazine, hydroxyzine), and antidiarrheal agents [ 71 ] .…”

Assessment of the Analgesic Effect of Centhaquin in Mouse Tail Flick and Hot-Plate Tests

“…Clonidine is known to potentiate analgesic effects of morphine [18] and other opioids [19][20][21] . The clinical use of clonidine and other ␣ 2 -adrenergic agonists as adjuvant analgesics [22][23][24][25] , in managing opioid tolerance and dependence [26,27] , as well as in managing opioid withdrawal [28][29][30] , is well documented. Clonidineinduced hypothermia is blocked by the ␣ 2 -adrenergic antagonist yohimbine [11,31] as well as by idazoxan, suggesting the involvement of imidazoline/ ␣ 2 -adrenergic receptors in clonidine-induced hypothermia.…”