A double-blind randomized placebo-controlled study of the efficacy of the combined treatment with naltrexone and guanfacine for relapse prevention in opiate dependence

Krupitsky E.M.; Blokhina E.A.; Zvartau É.É.; Verbitskaya E.V.; Bushara N.М.; Tyurina A.A.; Palatkin V.Ya.; Yaroslavtseva Т.S.; Burakov A.M.; Masalov D.V.; Romanova T.N.; Grinenko A.Ia.; Sinha R.; Kosten Т.

doi:https://doi.org/10.17116/jnevro201511510139-46

Krupitsky E.M.

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

Blokhina E.A.

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

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)

Verbitskaya E.V.

ORCID: 0000-0003-3770-993X

Bushara N.М.

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

Tyurina A.A.

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

ORCID: 0000-0001-6657-8081

Palatkin V.Ya.

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

Yaroslavtseva Т.S.

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

Burakov A.M.

Masalov D.V.

Romanova T.N.

Grinenko A.Ia.

Sinha R.

Yale University, Department of Psychiatry, New Haven, USA

Kosten Т.

Baylor College of Medicine, Houston, USA

A double-blind randomized placebo-controlled study of the efficacy of the combined treatment with naltrexone and guanfacine for relapse prevention in opiate dependence

Authors:

Krupitsky E.M., Blokhina E.A., Zvartau É.É., Verbitskaya E.V., Bushara N.М., Tyurina A.A., Palatkin V.Ya., Yaroslavtseva Т.S., Burakov A.M., Masalov D.V., Romanova T.N., Grinenko A.Ia., Sinha R., Kosten Т.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2015;115(10): 39‑46

DOI: 10.17116/jnevro201511510139-46

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To cite this article:

Krupitsky EM, Blokhina EA, Zvartau ÉÉ, et al. A double-blind randomized placebo-controlled study of the efficacy of the combined treatment with naltrexone and guanfacine for relapse prevention in opiate dependence. S.S. Korsakov Journal of Neurology and Psychiatry. 2015;115(10):39‑46. (In Russ.)
https://doi.org/10.17116/jnevro201511510139-46

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)

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Abstract:

Objective. Authors studied the effect of α-2-adrenoreceptor agonist guanfacine on replace prevention in opiate addicts. Material and methods. Three hundred and one recently detoxified opiate addicts were randomized under the double-blind double-dummy conditions into one of four treatment groups: naltrexone 50 mg/day + guanfacine 1 mg/day (N+G), naltrexone + guanfacine placebo (N+GP), naltrexone placebo + guanfacine (NP+G), and double placebo (NP+GP). The primary outcome was retention in treatment. The secondary outcomes were perceived stress (Perceived Stress Scale) and craving. Results. At the end of six months, 20 (26.7%) patients in the N+G group and 15 (19.7%) (p=0.26 to N+G) in N+GP group were retained in treatment compared to 5 (6.7%) in the NP+G group (p=0.002 to N+G group and p=0.017 to N+GP group) and 8 (10.7%) in the double placebo group (p=0.013 to N+G group). There is no significant difference in retention between the N+G group and N+GP group at the end of treatment. Conclusion. Guanfacine had significant craving and stress reducing effect. Naltrexone was more effective than placebo for relapse prevention in opioid dependent patients. The efficacy of the combination of naltrexone and guanfacine was comparable to naltrexone alone. Guanfacine moderately reduced both stress and craving.

Keywords:

naltrexone

guanfacine

opiate dependence

pharmacotherapy

stress

Authors:

Krupitsky E.M.

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

Blokhina E.A.

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

Zvartau É.É.

Verbitskaya E.V.

ORCID: 0000-0003-3770-993X

Bushara N.М.

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

Tyurina A.A.

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

ORCID: 0000-0001-6657-8081

Palatkin V.Ya.

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

Yaroslavtseva Т.S.

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

Burakov A.M.

Masalov D.V.

Romanova T.N.

Grinenko A.Ia.

Sinha R.

Yale University, Department of Psychiatry, New Haven, USA

Kosten Т.

Baylor College of Medicine, Houston, USA

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