A placebo-controlled trial of memantine as an adjunct to injectable extended-release naltrexone for opioid dependence
- PMID: 24560438
- PMCID: PMC4007510
- DOI: 10.1016/j.jsat.2014.01.005
A placebo-controlled trial of memantine as an adjunct to injectable extended-release naltrexone for opioid dependence
Abstract
There is preclinical support for using NMDA receptor glutamatergic antagonists to aid in naltrexone-based treatment of opioid dependence. We hypothesized that adding memantine will improve efficacy of extended-release (XR) naltrexone to prevent relapse. In this double blind study opioid-dependent participants (N=82) underwent inpatient detoxification and naltrexone induction. During naltrexone initiation participants were randomized to receive memantine 40 mg or placebo and continued treatment for 12-weeks with XR naltrexone and relapse-prevention therapy. Sixty eight percent of participants completed detoxification and received the first dose of XR naltrexone. Rates of trial completion were significantly greater in participants receiving placebo than memantine (70% vs. 43%, p<0.05). Severity of opioid withdrawal symptoms during the first 3 weeks of the trial appeared to be lower in the group receiving memantine (p=0.07). Adding memantine does not appear to increase the effectiveness of injectable XR naltrexone as a relapse prevention strategy in opioid dependence and may lead to an increase in treatment drop-out.
Keywords: Memantine; NMDA receptors; Naltrexone; Opiate dependence; Pharmacotherapy trials.
Copyright © 2014 Elsevier Inc. All rights reserved.
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References
-
- Bisaga A, Comer SD, Ward AS, Popik P, Kleber HD, Fischman MW. The NMDA antagonist memantine attenuates the expression of opioid physical dependence in humans. Psychopharmacology (Berl) 2001;157(1):1–10. - PubMed
-
- CASA Columbia, T. Addiction Medicine: Closing the Gap between Science and Practice. New York: The National Center on Addiction and Substance Abuse at Columbia University; 2012.
-
- CDC. CDC grand rounds: prescription drug overdoses - a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012;61(1):10–13. - PubMed
-
- Comer SD, Sullivan MA. Memantine produces modest reductions in heroin-induced subjective responses in human research volunteers. Psychopharmacology (Berl) 2007;193(2):235–245. - PubMed
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