title: Long-term opioid blockade and hedonic response: preliminary data from two open-label extension studies with extended-release naltrexone.
abstract: The emergence of extended-release naltrexone (XR-NTX) raises the opportunity to explore the role of endorphin blockade on hedonic response during long-term alcohol dependence treatment. A hedonic survey was administered to 74 alcohol dependent patients treated for an average of 3.5 years with nearly continuous month-long intramuscular XR-NTX. The paper-and-pencil, one-time survey asked patients about the degree of pleasure they experienced in the past 90 days with drinking alcohol, sex, exercise and other daily activities. The data revealed lower pleasure ratings for alcohol than for sex, exercise and 10 other common activities. Mean responses to drinking alcohol and gambling were significantly lower than to listening to music, sex, reading, being with friends, eating good food, eating spicy food, and playing video/card games. This effect was independent of XR-NTX dose or duration. Although this exploratory study lacked baseline data, a comparison group or control for the impact of patient discontinuation, the data indicate the feasibility of examining long-term hedonic response in recovery. The differential hedonic ratings suggest that, in patients who persist with long-term continuous therapy, XR-NTX may selectively inhibit the pleasure associated with drinking alcohol, compared to a variety of other activities.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. obrien@mail.trc.upenn
authors.forename: Charles P
authors.initials: CP
authors.lastname: O'Brien
authors.forename: David R
authors.initials: DR
authors.lastname: Gastfriend
authors.forename: Robert F
authors.initials: RF
authors.lastname: Forman
authors.forename: Edward
authors.initials: E
authors.lastname: Schweizer
authors.forename: Helen M
authors.initials: HM
authors.lastname: Pettinati
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000188:drug therapy / Q000523:psychology*; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D057181:Pleasure / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone