Comparison of acetorphan with clonidine for opiate withdrawal symptoms.
OBJECTIVE
The authors compared the effects of acetorphan, an enkephalinase inhibitor, with those of clonidine for the treatment of the opioid withdrawal syndrome. Nineteen patients addicted to heroin or synthetic opiates who were undergoing drug withdrawal and displayed a withdrawal syndrome according to DSM-III criteria were studied for 5 days in a hospital setting. In a double-blind trial, 10 subjects were given acetorphan intravenously and nine were given clonidine; objective signs and subjective symptoms of withdrawal were recorded.


RESULTS
On several objective signs, the effect of acetorphan was more marked than that of clonidine, whereas the two drugs exhibited similar efficacy with respect to the subjective components of withdrawal. No side effect was noted in the subjects who received acetorphan.


CONCLUSIONS
Enkephalinase inhibition may constitute a novel and safe therapeutic approach to the opioid withdrawal syndrome.
Hartmann
F
F
Service Hospitalo-Universitaire de Santé Mentale et de Thérapeutique, Centre Hospitalier Sainte-Anne, Paris, France.
Poirier
M F
MF
Bourdel
M C
MC
Loo
H
H
Lecomte
J M
JM
Schwartz
J C
JC
D000293:Adolescent; D000328:Adult; D003000:Clonidine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D008297:Male; D009294:Narcotics / Q000009:adverse effects; D015260:Neprilysin / Q000037:antagonists & inhibitors*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000209:etiology; D015244:Thiorphan / Q000031:analogs & derivatives* / Q000627:therapeutic use
D009294:Narcotics; D003932:Heroin; C049331:racecadotril; D015244:Thiorphan; D015260:Neprilysin; D003000:Clonidine