Evaluation of the reinforcing and subjective effects of heroin in combination with dextromethorphan and quinidine.
OBJECTIVE
Studies have suggested that the N-methyl-D-aspartate antagonist dextromethorphan may be useful in the treatment of opioid dependence.


METHODS
This double-blinded, placebo-controlled inpatient study evaluated the effects of 0, 30, and 60 mg of dextromethorphan and quinidine (DMQ) on the reinforcing and subjective effects of heroin in recently detoxified heroin abusers.


METHODS
Nine heroin-dependent participants were admitted and then detoxified from heroin over the course of several days.


METHODS
Participants were subsequently stabilized on 0, 30, or 60 mg of DMQ. Each dose of DMQ was administered for two consecutive weeks, and the effects of heroin (0, 12.5, and 50 mg) were studied under each DMQ maintenance dose condition. DMQ and heroin dose were administered in random order both within and between participants.


RESULTS
Planned comparisons revealed statistically significant increases in progressive ratio breakpoint values and positive subjective ratings as a function of heroin dose. There were no consistent changes in any of the responses as a function of DMQ maintenance dose, other than a modest reduction in craving.


CONCLUSIONS
In summary, results from this study suggest that maintenance on dextromethorphan in combination with quinidine has a limited role in the treatment of opioid dependence.
Department of Psychiatry New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, USA.
Suzanne K
SK
Vosburg
Maria A
MA
Sullivan
Sandra D
SD
Comer
D000328:Adult; D003915:Dextromethorphan / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000494:pharmacology*; D003932:Heroin / Q000008:administration & dosage / Q000494:pharmacology*; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D008297:Male; D011802:Quinidine / Q000008:administration & dosage / Q000494:pharmacology*; D012054:Reinforcement, Psychology; D012646:Self Administration
D004338:Drug Combinations; D018691:Excitatory Amino Acid Antagonists; C507057:dextromethorphan - quinidine combination; D003932:Heroin; D003915:Dextromethorphan; D011802:Quinidine