A synopsis of the pharmacological rationale, properties and therapeutic effects of depot preparations of naltrexone for treating alcohol dependence.
Although oral naltrexone has been shown to diminish alcohol reinforcement, its limitations as a medication include its small treatment effect size, plasma level fluctuation and adverse events. The pharmacokinetic profile of naltrexone could be optimised by intramuscular administration, sustaining its release over several weeks. As a result, plasma levels would remain relatively constant; high enough to reduce drinking, low enough to minimise side effects. Two injectable naltrexone depot preparations, Vivitrex and Naltrel, have been tested as pharmacotherapy for alcohol dependence. Their adverse-event profiles seem to be mild compared with oral naltrexone. Vivitrex has shown efficacy at reducing heavy drinking significantly among alcohol-dependent men. Naltrel helped reduce relapse and promote abstinence in two samples of alcohol-dependent individuals. Additional efficacy studies are warranted.
Johnson
Bankole A
BA
Department of Psychiatric Medicine, University of Virginia, PO Box 800623, Charlottesville, VA 22908-0623, USA. bankolejohnson@virginia.edu
D000284:Administration, Oral; D000437:Alcoholism / Q000188:drug therapy*; D000818:Animals; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D009271:Naltrexone / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D013810:Therapeutic Equivalency
D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone