title: Clinical experience about an unexpected adverse event during nalmefene treatment in two patients with alcohol use disorder.
abstract: OBJECTIVE
  Nalmefene, a new opioid system regulator, has recently been approved for the treatment of alcohol dependence, primarily for reducing heavy drinking days.
  
  
  METHODS
  Two patients with a diagnosis of alcohol use disorder were treated with nalmefene. Both patients developed fatigue and deep sleepiness after 2 days of treatment. Only after 1 day of drug discontinuation, symptoms normalized.
  
  
  CONCLUSIONS
  We have analysed symptoms' development before and after treatment discontinuation and the possible association with nalmefene therapy. This case should pinpoint our attention on this adverse event for a careful choice of anticraving therapy in patients with severe alcohol use disorder.
authors.affiliation: Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Milano
authors.affiliation: Department of Dependence (Ser.T.), ASL-Al, Alessandria, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Zavan
authors.affiliation: Neurology Unit, Istituto Clinico 'Salus', Alessandria, Italy.
authors.forename: W M
authors.initials: WM
authors.lastname: Natta
authors.affiliation: Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Martelli
authors.affiliation: Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Mattioli
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000188:drug therapy*; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone; C038981:nalmefene
keywords: adverse event; alcohol dependence; as-needed use; nalmefene