title: [A double-blind randomized placebo-controlled study of the efficacy of the combined treatment with naltrexone and guanfacine for relapse prevention in opiate dependence].
abstract: OBJECTIVE
  Authors studied the effect of α-2-adrenoreceptor agonist guanfacine on replace prevention in opiate addicts.
  
  
  METHODS
  Three hundred and one recently detoxified opiate addicts were randomized under the double-blind double-dummy conditions into one of four treatment groups: naltrexone 50 mg/day+guanfacine 1 mg/day (N+G), naltrexone+guanfacine placebo (N+GP), naltrexone placebo+guanfacine (NP+G), and double placebo (NP+GP). The primary outcome was retention in treatment. The secondary outcomes were perceived stress (Perceived Stress Scale) and craving.
  
  
  RESULTS
  At the end of six months, 20 (26.7%) patients in the N+G group and 15 (19.7%) (p=0.26 to N+G) in N+GP group were retained in treatment compared to 5 (6.7%) in the NP+G group (p=0.002 to N+G group and p=0.017 to N+GP group) and 8 (10.7%) in the double placebo group (p=0.013 to N+G group). There is no significant difference in retention between the N+G group and N+GP group at the end of treatment.
  
  
  CONCLUSIONS
  Guanfacine had significant craving and stress reducing effect. Naltrexone was more effective than placebo for relapse prevention in opioid dependent patients. The efficacy of the combination of naltrexone and guanfacine was comparable to naltrexone alone. Guanfacine moderately reduced both stress and craving.
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg; Bekhterev St. Petersburg Research Psychoneurological Institute, St. Petersburg.
authors.forename: E M
authors.initials: EM
authors.lastname: Krupitsky
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: E A
authors.initials: EA
authors.lastname: Blokhina
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: E E
authors.initials: EE
authors.lastname: Zvartau
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: V E
authors.initials: VE
authors.lastname: Verbitskaya
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: E M
authors.initials: EM
authors.lastname: Bushara
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: A A
authors.initials: AA
authors.lastname: Tiurina
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: V Ya
authors.initials: VY
authors.lastname: Palatkin
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: T S
authors.initials: TS
authors.lastname: Yaroslavtseva
authors.affiliation: Leningrad Obllast Narcological Dispensary, Leningrad oblast.
authors.forename: A M
authors.initials: AM
authors.lastname: Burakov
authors.affiliation: Leningrad Obllast Narcological Dispensary, Leningrad oblast.
authors.forename: D V
authors.initials: DV
authors.lastname: Masalov
authors.affiliation: Leningrad Obllast Narcological Dispensary, Leningrad oblast.
authors.forename: T N
authors.initials: TN
authors.lastname: Romanova
authors.affiliation: Pavlov First St. Petersburg State Medical University, St. Petersburg.
authors.forename: A Ya
authors.initials: AY
authors.lastname: Grininko
authors.affiliation: Yale University, Department of Psychiatry, New Haven, USA.
authors.forename: R
authors.initials: R
authors.lastname: Sinha
authors.affiliation: Beylor College of Medicine, Houston, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kosten
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D016316:Guanfacine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000517:prevention & control; D012008:Recurrence; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D016316:Guanfacine; D009271:Naltrexone