Anhedonia, depression, anxiety, and craving in opioid dependent patients stabilized on oral naltrexone or naltrexone implant

Krupitskiĭ E.M.

Sankt-Peterburgskiĭ nauchno-issledovatel'skiĭ psikhonevrologicheskiĭ institut im. V.M. Bekhtereva

Zvartau É.É.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.P. Pavlova;
Sankt-Peterburgskiĭ nauchno-issledovatel'skiĭ psikhonevrologicheskiĭ institut im. V.M. Bekhtereva;
fakul'tet psikhiatrii Universiteta shtata Pensil'vaniia (SShA)

Blokhina E.A.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

Verbitskaia E.V.

Wahlgren V.Yu.

Valdman Institute of Pharmacology of Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia

Tsoĭ-Podosenin M.V.

Bushara N.М.

Pavlov First St. Petersburg State Medical University, St. Petersburg

Burakov A.M.

Masalov D.V.

Romanova T.N.

Tyurina A.A.

Obstetrics and Gynecology Department Two, Bashkir State Medical University, Ufa, Russia

Palatkin V.Ya.

Pavlov First St. Petersburg State Medical University, St. Petersburg

Yaroslavtseva Т.S.

Pavlov First St. Petersburg State Medical University, St. Petersburg

Sulimov G.Yu.

Fidelity Capital, Moscow

Pecoraro A.

Department of Psychiatry, University of Pennsylvania, Phyladelphia, USA

Woody G.

Department of Psychiatry, University of Pennsylvania, Phyladelphia, USA

Anhedonia, depression, anxiety, and craving in opioid dependent patients stabilized on oral naltrexone or naltrexone implant

Authors:

Krupitskiĭ E.M., Zvartau É.É., Blokhina E.A., Verbitskaia E.V., Wahlgren V.Yu., Tsoĭ-Podosenin M.V., Bushara N.М., Burakov A.M., Masalov D.V., Romanova T.N., Tyurina A.A., Palatkin V.Ya., Yaroslavtseva Т.S., Sulimov G.Yu., Pecoraro A., Woody G.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(1‑2): 26‑33

DOI: 10.17116/jnevro20181181226-33

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To cite this article:

Krupitskiĭ EM, Zvartau ÉÉ, Blokhina EA, et al. . Anhedonia, depression, anxiety, and craving in opioid dependent patients stabilized on oral naltrexone or naltrexone implant. S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(1‑2):26‑33. (In Russ.)
https://doi.org/10.17116/jnevro20181181226-33

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Objective. To assess the relationship between long-term naltrexone treatment and anxiety, depression and craving in opioid dependent individuals. Material and 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 Inventory, 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 post hoc Tukey test. Results and conclusion. Anhedonia, depression, anxiety, and craving for opiates were elevated at baseline but gradually reduced to normal within the first 1—2 months for patients who remained in treatment and did not relapse. There were no significant between-group differences prior to treatment dropout as well as between those who relapsed and who continued on naltrexone. Conclusion. These data do not support concerns that naltrexone treatment of opioid dependence precipitates anhedonia, depression, anxiety or craving for opiates.

Keywords:

naltrexone

opioid dependence

anhedonia

Authors:

Krupitskiĭ E.M.

Sankt-Peterburgskiĭ nauchno-issledovatel'skiĭ psikhonevrologicheskiĭ institut im. V.M. Bekhtereva

Zvartau É.É.

Blokhina E.A.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

Verbitskaia E.V.

Wahlgren V.Yu.

Valdman Institute of Pharmacology of Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia

Tsoĭ-Podosenin M.V.

Bushara N.М.

Pavlov First St. Petersburg State Medical University, St. Petersburg

Burakov A.M.

Masalov D.V.

Romanova T.N.

Tyurina A.A.

Obstetrics and Gynecology Department Two, Bashkir State Medical University, Ufa, Russia

Palatkin V.Ya.

Pavlov First St. Petersburg State Medical University, St. Petersburg

Yaroslavtseva Т.S.

Pavlov First St. Petersburg State Medical University, St. Petersburg

Sulimov G.Yu.

Fidelity Capital, Moscow

Pecoraro A.

Department of Psychiatry, University of Pennsylvania, Phyladelphia, USA

Woody G.

Department of Psychiatry, University of Pennsylvania, Phyladelphia, USA

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