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Anhedonia, depression, anxiety, and craving in opiate dependent patients stabilized on oral naltrexone or an extended release naltrexone implant.

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Title: Anhedonia, depression, anxiety, and craving in opiate dependent patients stabilized on oral naltrexone or an extended release naltrexone implant.
Authors: Krupitsky, Evgeny (AUTHOR), Zvartau, Edwin (AUTHOR), Blokhina, Elena (AUTHOR), Verbitskaya, Elena (AUTHOR), Wahlgren, Valentina (AUTHOR), Tsoy-Podosenin, Marina (AUTHOR), Bushara, Natalia (AUTHOR), Burakov, Andrey (AUTHOR), Masalov, Dmitry (AUTHOR), Romanova, Tatyana (AUTHOR), Tyurina, Arina (AUTHOR), Palatkin, Vladimir (AUTHOR), Yaroslavtseva, Tatyana (AUTHOR), Pecoraro, Anna (AUTHOR), Woody, George (AUTHOR)
Source: American Journal of Drug & Alcohol Abuse. Sep2016, Vol. 42 Issue 5, p614-620. 7p.
Subjects: Anhedonia, Mental depression, Anxiety, Desire, Opioid abuse, Naltrexone, Comparative studies, Controlled release preparations, Controlled release drugs, Research methodology, Medical cooperation, Oral drug administration, Psychological tests, Research, Research funding, Substance abuse, Evaluation research, Randomized controlled trials, Treatment effectiveness, Blind experiment, Therapeutics
Abstract: Background: Naltrexone is a μ-opioid receptor antagonist that blocks opioid effects. Craving, depression, anxiety, and anhedonia are common among opioid dependent individuals and concerns have been raised that naltrexone increases them due to blocking endogenous opioids. Here, we present data that address these concerns.Objective: Assess the relationship between affective responses and naltrexone treatment.Methods: Opioid dependent patients (N = 306) were enrolled in a three cell (102ss/cell) randomized, double blind, double dummy, placebo-controlled 6-month trial comparing extended release implantable naltrexone with oral naltrexone and placebo (oral and implant). Monthly assessments of affective responses used a Visual Analog Scale for opioid craving, the Beck Depression Inventory, Spielberger Anxiety Test, and the Ferguson and Chapman Anhedonia Scales. Between-group outcomes were analyzed using mixed model analysis of variance (Mixed ANOVA) and repeated measures and the Tukey test for those who remained and treatment and did not relapse, and between the last measure before dropout with the same measure for those remaining in treatment.Results: Depression, anxiety, and anhedonia were elevated at baseline but reduced to normal within the first 1-2 months for patients who remained in treatment and did not relapse. Other than a slight increase in two anxiety measures at week two, there were no significant between-group differences prior to treatment dropout.Conclusion: These data do not support concerns that naltrexone treatment of opioid dependence increases craving, depression, anxiety or anhedonia. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Drug & Alcohol Abuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Anhedonia, depression, anxiety, and craving in opiate dependent patients stabilized on oral naltrexone or an extended release naltrexone implant.
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  Data: <searchLink fieldCode="AR" term="%22Krupitsky%2C+Evgeny%22">Krupitsky, Evgeny</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zvartau%2C+Edwin%22">Zvartau, Edwin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Blokhina%2C+Elena%22">Blokhina, Elena</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Verbitskaya%2C+Elena%22">Verbitskaya, Elena</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wahlgren%2C+Valentina%22">Wahlgren, Valentina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tsoy-Podosenin%2C+Marina%22">Tsoy-Podosenin, Marina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bushara%2C+Natalia%22">Bushara, Natalia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burakov%2C+Andrey%22">Burakov, Andrey</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Masalov%2C+Dmitry%22">Masalov, Dmitry</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Romanova%2C+Tatyana%22">Romanova, Tatyana</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tyurina%2C+Arina%22">Tyurina, Arina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Palatkin%2C+Vladimir%22">Palatkin, Vladimir</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yaroslavtseva%2C+Tatyana%22">Yaroslavtseva, Tatyana</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pecoraro%2C+Anna%22">Pecoraro, Anna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Woody%2C+George%22">Woody, George</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Drug+%26+Alcohol+Abuse%22">American Journal of Drug & Alcohol Abuse</searchLink>. Sep2016, Vol. 42 Issue 5, p614-620. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Anhedonia%22">Anhedonia</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Desire%22">Desire</searchLink><br /><searchLink fieldCode="DE" term="%22Opioid+abuse%22">Opioid abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Naltrexone%22">Naltrexone</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Controlled+release+preparations%22">Controlled release preparations</searchLink><br /><searchLink fieldCode="DE" term="%22Controlled+release+drugs%22">Controlled release drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Oral+drug+administration%22">Oral drug administration</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+tests%22">Psychological tests</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+research%22">Evaluation research</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Blind+experiment%22">Blind experiment</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Naltrexone is a μ-opioid receptor antagonist that blocks opioid effects. Craving, depression, anxiety, and anhedonia are common among opioid dependent individuals and concerns have been raised that naltrexone increases them due to blocking endogenous opioids. Here, we present data that address these concerns.<bold>Objective: </bold>Assess the relationship between affective responses and naltrexone treatment.<bold>Methods: </bold>Opioid dependent patients (N = 306) were enrolled in a three cell (102ss/cell) randomized, double blind, double dummy, placebo-controlled 6-month trial comparing extended release implantable naltrexone with oral naltrexone and placebo (oral and implant). Monthly assessments of affective responses used a Visual Analog Scale for opioid craving, the Beck Depression Inventory, Spielberger Anxiety Test, and the Ferguson and Chapman Anhedonia Scales. Between-group outcomes were analyzed using mixed model analysis of variance (Mixed ANOVA) and repeated measures and the Tukey test for those who remained and treatment and did not relapse, and between the last measure before dropout with the same measure for those remaining in treatment.<bold>Results: </bold>Depression, anxiety, and anhedonia were elevated at baseline but reduced to normal within the first 1-2 months for patients who remained in treatment and did not relapse. Other than a slight increase in two anxiety measures at week two, there were no significant between-group differences prior to treatment dropout.<bold>Conclusion: </bold>These data do not support concerns that naltrexone treatment of opioid dependence increases craving, depression, anxiety or anhedonia. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of American Journal of Drug & Alcohol Abuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1080/00952990.2016.1197231
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      – Code: eng
        Text: English
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        StartPage: 614
    Subjects:
      – SubjectFull: Anhedonia
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Desire
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      – SubjectFull: Opioid abuse
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      – SubjectFull: Naltrexone
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      – SubjectFull: Medical cooperation
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      – SubjectFull: Oral drug administration
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      – SubjectFull: Therapeutics
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