An uncontrolled clinical trial was conducted to investigate the effect of Naltrexone and Cognitive Behavioral Therapy (CBT) on relapse prevention in Green Center, Hochiminh city from October 2002 to August 2003. The sample included 106 addicts (94.3% males) who just passed the acute detoxification process. Patients came to the Green Center 3 times per week (every other day), took 100 mg Naltrexone (150mg on weekend) at the Center, and then got a CBT session in one hour. The Naltrexone-CBT program was prolonged in 6 months. The results: 65/106 (61.3%) patients have terminated the treatment course, in which, only 4 patients (6.2%) followed the whole program (6 months); 7 patients (10.8%) have followed 3 - 6 months. The average of treatment duration was 56.7  51.8 days. There were 29.2% addicts have relapsed, in which the relapse rate of addicts, who have followed the whole program in 6 months was 0%; of addicts who had the treatment duration from 3 – 6 months was 5.3%; and of addicts with the treatment duration less than 2 months was 89.4%. The main recognized reasons for the great drop-out rate were the familial interference which a tendency of shortening the treatment course just after 3 months abstinence of their offspring (27.7%), the high cost of the treatment in comparison to the average income of most people (18.5%), the treatment center is too far from addicts home (16.9%)
Naltrexone ; Cognitive Therapy ; prevention & control

Prurigo nodularis is a distressing, chronic disease, which is considered to be very resistant to therapy. Treatment choice is quite limited. Among them, opiate antagonist and phototherapy have been used with satisfactory results. We report a case of treatment-resistant prurigo nodularis. Narrow band-UVB phototherapy was performed twice weekly for 3 months. Naltrexone 50mg was also taken daily before sleep. Pruritus was midly reduced after 1 week, and had almost completely disappeared after 3 months of treatment.
Chronic Disease ; Naltrexone* ; Phototherapy ; Prurigo* ; Pruritus

Naltrexone in combining with the counselling, the familial intervention, the behaviorial management… was used at the Institute of Mental Health. After 1 month, the default had got 8.16%, after 3 months 14.28%. In all cases of normal SGOT, SGPT level before the treatment had got no change in the course of treatment, but in cases of increased enzyme levels before the treatment, they were abnormally changed. Urine test was (+) with narcotic drugs after 1 month 44%, 2 months 32.14%, 3 months 34.14%, 4 months 43.75%, 5 months 28%, 6 months 22.5%. A majority of addictive subjects did not believe on the clearing of heroine effect by naltrexone and some had got no correct motivation for the treatment. Criminal beheavior contrainted in the family was eliminated entirely after 1 to 2 months treatment. High risk beheavior among intravenous drug users, unsafe sexual activities were ceased after 1 month treatment. No HIV(+) patient was detected after 6 months treatment.
Analgesics, Opioid ; Therapeutics ; Morphine Dependence ; Naltrexone

OBJECTIVE: This study compared the effects of opioids antagonist naltrexone and serotonin-dopamine recepter antagonist olanzapine on the reduction of alcohol consumption level of alcohol intake reinforced C57BL-6 type rat. METHODS: Small amount of alcohol and water were applied to the 28 rats for 2 hours per day during 30 days. On the 31th day, The rats were divided into four groups and given different medications by intraabdominal route 30 minutes before the alcohol consumption. For the next 35 days, the 3 subject group were applied with naltrexone 5mg/kg, olanzapine 0.1mg/kg and olanzapine 1.0mg/kg and the control group with distilled water everyday. RESULTS: In contrast to control group, naltrexone 5mg/kg group showed a significant reduction of alcohol consumption after 4 weeks. Olanzapine 0.1mg/kg group showed a decrease of alcohol consumption from 2 to 5 week period. Although olanzapine 1mg/kg group showed a momentary decrease of the consumption during the 2nd and 3rd weeks, the group did not show significant decrease afterwards. Olanzapine 0.1mg/kg was more effective in reducing the alcohol consumption than olanzapine 1mg/kg. However, it is not significantly more effective compared to the naltrexone 5mg/kg in reducing the alcohol consumption of the reinforced rats' alcohol intake. CONCLUSION: This results suggest that the low dose of olanzapine as well as naltrexone reduce the alcohol intake in C57BL-6 type rats.
Alcohol Drinking* ; Alcoholism ; Analgesics, Opioid ; Animals ; Naltrexone* ; Rats* ; Water

OBJECTIVES: For the relapse prevention in alcohol dependence, a lot of studies suggested that combined administration of two or more drugs which have different mechanism of action is more effective than each drug alone. In order to investigate the effectiveness of combined administration of naltrexone and acamprosate in comparison with naltrexone alone, this study was carried out by comparing the amount of alcohol intake in C57BL/6 mice co-administered with naltrexone and acamprosate with that in C57BL/6 mice with naltrexone alone. METHODS: In 42 C57BL/6 mice in the state of alcohol dependence, naltrexone 0.025mg/kg or 1.0mg/kg alone or with acamprosate 50mg/kg or 200mg/kg were administrated for ten days. The amounts of alcohol consumption for 2 hour, water consumption for 22 hours, and food intake for 24 hours were measured. RESULTS: 1) A significant reduction of alcohol intake for 2 hours was observed when the mice were treated with naltrexone 0.025mg/kg or 1.0mg/kg and acamprosate 50mg/kg or 200mg/kg simultaneously compared with naltrexone 0.025mg/kg or 1.0mg/kg alone. This effect was significant on the eighth and tenth days of drug administration. 2) Naltrexone administration of 1.0mg/kg was significantly more effective than that of 0.025 mg/kg in reducing alcohol intake from the second day of drug administration up to the tenth day. 3) No significant difference was revealed between the effect of naltrexone alone and that of naltrexone with acamprosate on 22 hour water consumption and 24 hour food intake. CONCLUSION: From these results, it is suggested that the effect of combined treatment with naltrexone and acamprosate is superior to that of naltrexone alone in prevention of relapse in alcohol dependence.
Alcohol Drinking ; Alcoholism ; Animals ; Drinking ; Eating ; Mice* ; Naltrexone* ; Recurrence

Pathological gambling is classified as impulse control disorder in DSM-IV, but in clinical aspects it is similar with addictive disorder. Hence some pharmacological agents which are used to addictive disorders could be effective to pathological gambling. The author summarizes and discusses the treatment study results of mood stabilizers, serotonin reuptake inhibitors, naltrexone and other potentially promising agents. Recent double-blind, placebo-controlled studies show SSRIs and naltrexone effective to reduce urges of gamblers. However further studies with large patient population and longer treatment duration are required. The author also discusses cognitive behavioral treatment, family education and Gamblers Anony-mous (GA). Western cognitive behavioral treatment consists of cognitive correction, problem solving technique, social skill training and relapse prevention, but we need to modify these rechnics to fit to our clinical population.
Diagnostic and Statistical Manual of Mental Disorders ; Education ; Gambling* ; Humans ; Naltrexone ; Problem Solving ; Recurrence ; Serotonin Uptake Inhibitors

The comprehensive medical care delivered by family physicians should involve education and practice of health-sustaining habits such as diet, exercise, relaxation etc. as well as drug prescription. Among those, problem drinking is one of the most frequent issues encountered in health promoting sessions. However they are not competent to cover the realm of counseling in problem drinking in a continuous way. The drinking problems go up, unnoticed and uninhibited, to the self-destructive stages by the process of denial and avoidance on the part of patient as well as therapists. The explanation by which moderate drinking can't be easily embedded into healthy life styles and the practical strategies for dealing with problem drinkers and alcohol dependents will be presented in the context of health-sustaining habits.
Counseling ; Denial (Psychology) ; Diet ; Drinking ; Drug Prescriptions ; Humans ; Life Style ; Naltrexone ; Physicians, Family ; Relaxation

BACKGROUND: Severe pruritus is a challenging condition, and it is more difficult to deal with in older patients due to their limitations in taking oral medication because of underlying diseases, possible interaction with concurrent medications, and poor general condition. OBJECTIVE: We evaluated the efficacy and safety of naltrexone (Revia®), an opioid antagonist, in elderly patients with severe pruritus that was not easily controlled with conventional antipruritics. METHODS: Eighteen patients were enrolled, with a mean age of 73 years. They additionally received 50 mg of naltrexone per day for an average of 2 months. RESULTS: Using the visual analogue scale, 13 (72.2%) of 18 patients showed a "much improved" condition, reporting more than a 50% decrease in pruritus intensity. Sixteen (88.9%) showed symptomatic improvement, and only 2 (11.1%) had persistent pruritus. Five patients reported side effects including insomnia, fatigue, constipation, and anorexia. However, reactions were either limited to the first 2 weeks or well managed. CONCLUSION: Naltrexone could be an effective and safe alternative treatment option to control severe pruritus in older patients.
Aged ; Anorexia ; Antipruritics ; Constipation ; Fatigue ; Humans ; Naltrexone* ; Pruritus* ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: Both capsaicin, a pungent substance of hot food, and alcohol, are known to affect central opioid activity. The purpose of this study was to investigate the difference in the subjective acute responses to alcohol and the effect of naltrexone on them among those who prefer hot food to varying degrees. METHODS: Twelve male medical students were divided into two groups using a cross-over design. One group was given naltrexone on only the first (25 mg) and the second day (50 mg), and the other group was given naltrexone on only the eighth (25 mg) and the ninth day (50 mg). On the second and the ninth day, the acute effect of alcohol was assessed in all subjects, using the Biphasic Alcohol Effects Scale (BAES) just before drinking and at 15 minutes, 30 minutes and 60 minutes after drinking (0.6 ml/kg). Alcohol craving was also measured, using Visual Analogue Scale for craving (VAS-C) and blood alcohol concentration (BAC), at the same interval. For statistical analysis, subjects of both group were re-divided into two group, those with a strong preference and those with a less preference (LP) for hot (spicy) food (SP), using the Food Preference Scale. RESULTS: 1) Repeated measures of ANOVA (2 preference groups x 4 time blocks) on the stimulative subscale of BAES yielded no significant group by block interaction of naltrexone administration. Repeated measures of ANOVA (2 drug groups x 4 time blocks) on the stimulative subscale of BAES revealed a significant group by block interaction in SP (p=0.028), but not in LP. The paired t-test revealed that significant suppression of the stimulative subscale of BAES was observed at 15 minutes and 30 minutes after drinking when naltrexone condition was compared with no-medication condition in SP (p=0.014; p=0.007). 2) For the sedative subscale of BAES, VAS-C and BAC, repeated measures of ANOVA yielded no significant group by block interaction by either hot food preference or naltrexone administration. CONCLUSION: For those who prefer hot food, the effect of stimulative acute alcohol was suppressed by naltrexone. This result strongly suggests that naltrexone could prevent relapse more effectively in those who prefer hot food.
Capsaicin ; Cross-Over Studies ; Drinking ; Food Preferences* ; Humans ; Male ; Naltrexone ; Recurrence ; Students, Medical

It was not above two or three decades from the changes began that regarding nicotine dependence as a kind of addictive disorder and a therapeutic target. Despite the short period of history, lots of medications were developed and showing significant clinical outcomes. In this review, we introduce the both of medications available at this time and in the status of developing for nicotine dependence. The clinical efficacies, practical ways of prescription, and common adverse events of the medications currently available are described through the survey of literatures. The novel medications in the process of developing are arranged by the proposed mechanism of action and summarized the phases of clinical trials at present. Among the diverse pharmacological tools now available, nicotine replacement and bupropion could be the first-line recommendation drugs and nortriptyline and clonidine could be the second-line recommendation drugs. Other medications like several antidepressants (e.g., moclobemide), buspirone, and naltrexone may be helpful in some specific population. Most of medications currently available have uncertainties in the aspects of their mechanisms of action except nicotine replacement materials; however, medications in developing have clearer neurobiological basis in their applications. Therefore, we can expect higher treatment outcomes by new products. Additionally, introduction of nicotine vaccines for high-risk group is drawing near. It could be possible for the individualizing for strategies of smoking cessation according to the patients' specific situation in a future.
Antidepressive Agents ; Bupropion ; Buspirone ; Clonidine ; Naltrexone ; Nicotine* ; Nortriptyline ; Prescriptions ; Smoking Cessation ; Tobacco Use Disorder* ; Vaccines