Pharmacopsychiatry 2010; 43(4): 130-137
DOI: 10.1055/s-0029-1242820
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Ultra-Rapid Opiate Detoxification Followed by Nine Months of Naltrexone Maintenance Therapy in Iran

A. Naderi-Heiden1 , A. Naderi2 , M. M. Naderi1 , F. Rahmani-Didar3 , A.-R. Salimi4 , A. Gleiss5 , S. Kasper1 , R. Frey1
  • 1Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
  • 2Department of Anesthesiology, Sadra Surgical Center, Tehran, Iran
  • 3Department of Anesthesiology, Naja Hospital, Tehran, Iran
  • 4Loghman-Hakim Hospital Poison Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
  • 5Core Unit for Medical Statistics and Informatics, Section of Clinical Biometrics, Medical University of Vienna, Vienna, Austria
Further Information

Publication History

received 16.02.2009 revised 06.10.2009

accepted 13.10.2009

Publication Date:
25 January 2010 (online)

Abstract

Introduction: The aim of this retrospective study was to assess ultra-rapid opiate detoxification (UROD) and to estimate the retention rate in naltrexone maintenance treatment.

Methods: 45 opiate-addicted male patients (DSM-IV 304.00; opiate per oral or per inhalation n=40, heroin intravenous n=5; concomitant cannabis abuse n=6) were detoxified by 6 h of naloxone infusion under general anesthesia with midazolam, propofol, clonidine and atracurium. Withdrawal signs were evaluated by the objective opiate withdrawal scale (OOWS, range 0–13) up to 24 h after awakening. After UROD, naltrexone 50 mg/day was prescribed for 9 months with assessments in 4-week intervals.

Results: Adverse events after UROD were prolonged unconsciousness (n=1), transient confusion (n=8) and depressive mood (n=6). The total sample showed a median OOWS score of 2 (mild withdrawal syndrome). The only two extreme outliers were found only in the subgroups “intravenous” (score 8) and “cannabis” (score 11). 96% (43/45) of the patients could be discharged the day after UROD. Thirty-six patients (80%) continued naltrexone therapy for the entire 9-month observation period.

Discussion: UROD and subsequently induction of naltrexone maintenance therapy can be regarded as safe and effective in patients with pure opiate addiction. Owing to cultural and economical factors our Iranian results may not correspond to European and American treatment modalities.

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Correspondence

A. Naderi-HeidenMD 

Division of Biological Psychiatry

Department of Psychiatry and Psychotherapy

Medical University of Vienna

Waehringer Guertel 18–20

1090 Vienna

Austria

Phone: +43/1/40/400 3568

Fax: +43/1/40/400 3099

Email: angela.naderi-heiden@meduniwien.ac.at

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