title: Accelerated lofexidine treatment regimen compared with conventional lofexidine and methadone treatment for in-patient opiate detoxification.
abstract: This open study compares an accelerated 5-day lofexidine regimen with orthodox 10-day lofexidine and methadone regimens in the treatment of opiate withdrawal in 61 polysubstance abusing opiate addicts. Significant differences in levels of withdrawal symptoms were found on days 11, 13-15 and 17-20, symptoms resolving most rapidly in the 5-day lofexidine treatment group, whilst withdrawal responses in the 10-day lofexidine treatment group were intermediate between the 5-day lofexidine and standard methadone treatment conditions. When the two lofexidine regimens were separately compared with methadone the 5-day lofexidine treatment was significantly more effective on day 10, 11 and 13-20, whilst the 10-day lofexidine treatment was not significantly different from methadone. There were no significant differences in rates of completion of detoxification between the three treatments. Both the lofexidine treatment regimens had a similar effect on blood pressure. Five patients experienced side effects which resolved with dose reduction, all remaining in the study. An accelerated 5-day lofexidine regimen may attenuate opiate withdrawal symptoms more rapidly than conventional 10-day lofexidine or methadone treatment schedules without exacerbating hypotensive side effects.
authors.affiliation: National Addiction Centre, Maudsley Institute of Psychiatry, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Bearn
authors.forename: M
authors.initials: M
authors.lastname: Gossop
authors.forename: J
authors.initials: J
authors.lastname: Strang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003000:Clonidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D003000:Clonidine; D008691:Methadone; C025655:lofexidine