Medication of l-tetrahydropalmatine significantly ameliorates opiate craving and increases the abstinence rate in heroin users: a pilot study.
OBJECTIVE
Drug addiction is a chronic brain disease with constant relapse requiring long-term treatment. New pharmacological strategies focus on the development of an effective antirelapse drug. This study examines the effects of levotetrahydropalmatine (l-THP) on reducing heroin craving and increasing the abstinence rate among heroin-dependent patients.


METHODS
In total, 120 heroin-dependent patients participated in the randomized, double-blinded, and placebocontrolled study using l-THP treatment. The participants remained in a ward during a 4-week period of l-THP treatment, followed by 4 weeks of observation after treatment. The patients were followed for 3 months after discharge. Outcome measures are the measured severity of the protracted abstinence withdrawal syndrome (PAWS) and the abstinence rate.


RESULTS
Four weeks of l-THP treatment significantly ameliorated the severity of PAWS, specifically, somatic syndrome, mood states, insomnia, and drug craving, in comparison to the placebo group. Based on the 3 month follow-up observation, participants who survived the initial 2 weeks of l-THP medication and remained in the trial program had a significantly higher abstinence rate of 47.8% (95% confidence interval [CI]: 33%- 67%) than the 15.2% in the placebo group (95% CI: 7%-25%), according to a log- rank test (P<0.0005).


CONCLUSIONS
l-THP significantly ameliorated PAWS, especially reducing drug craving. Furthermore, it increased the abstinence rate among heroin users. These results support the potential use of l-THP for the treatment of heroin addiction.
Beijing Institute of Basic Medical Science, Beijing 100005, China.
Zheng
Z
Yang
Yong-cong
YC
Shao
Shi-jiang
SJ
Li
Jian-lin
JL
Qi
Mei-jie
MJ
Zhang
Wei
W
Hao
Guo-zhang
GZ
Jin
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D001600:Berberine Alkaloids / Q000627:therapeutic use*; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D010865:Pilot Projects; D055502:Secondary Prevention; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D001600:Berberine Alkaloids; C014215:tetrahydropalmatine