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Background: Pharmacotherapy, such as oral naltrexone, has proven effective in treating alcohol use disorder, although medication adherence has presented challenges. Although a formulation of extended-release naltrexone for intramuscular injection has been developed to counter daily adherence issues, injection-site reactions can occur within days of depot injection.
Case: The authors report a case of an individual with alcohol use disorder who had a previously undescribed delayed injection-site reaction that occurred 11 days after injection. Subsequent challenge with the medication resulted in recurrence of the reaction.
Discussion: Although extended-release naltrexone is generally well tolerated, injection-site reactions can complicate treatment and can appear more than 10 days after medication administration.
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http://dx.doi.org/10.1080/08897077.2016.1138919 | DOI Listing |
JAMA Pediatr
September 2025
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Importance: For the first time in nearly 2 decades, the US infant mortality rate has increased, coinciding with a rise in overdose-related deaths as a leading cause of pregnancy-associated mortality in some states. Prematurity and low birth weight-often linked to opioid use in pregnancy-are major contributors.
Objective: To assess the health and economic impact of perinatal opioid use disorder (OUD) treatment on maternal and postpartum health, infant health in the first year of life, and infant long-term health.
J Opioid Manag
September 2025
Retired Addiction Physician and Psychiatrist, London SE1, United Kingdom. ORCID: https://orcid.org/0000-0002-5035-5833.
Despite the contribution of the µ-agonist fentanyl to the United States's opiate overdose epidemic, no human studies specifically address the ability of extended-release preparations of the opiate antagonist naltrexone (NTX) to block fentanyl's life-threatening µ-agonist-mediated respiratory depression. This paper presents three case histories of clinically necessary opiate challenges in opiate-abusing patients implanted with extended-release NTX (ER-NTX). It also reviews the sparse literature and is the first evidence that antagonist blood levels from ER-NTX preparations can completely block the lethal µ-agonist effects of at least 1,000 mcg of intravenous fentanyl.
View Article and Find Full Text PDFJ Clin Psychiatry
July 2025
Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas.
This study evaluated whether depressive symptom severity improved early with extended-release naltrexone and bupropion combination (naltrexone bupropion) compared to a placebo in individuals with moderate/severe methamphetamine use disorder and predicted subsequent use of methamphetamine. This secondary analysis from the Accelerated Development of Additive Pharmacotherapy Treatment for Methamphetamine Use Disorder (ADAPT-2) trial, which was conducted from May 23, 2017-July 25, 2019, included 326 individuals with a 9-item Patient Health Questionnaire (PHQ-9) score ≥5 at baseline. Repeated-measures mixed model analyses evaluated early (baseline-to-week-4) changes in depressive symptom severity with naltrexone-bupropion versus placebo and provided slope estimates for PHQ-9 change.
View Article and Find Full Text PDFPediatr Open Sci
April 2025
Boston University Chobanian & Avedisian School of Medicine, Department of Medicine, and Boston Medical Center, Boston, MA.
Objective: Medications for opioid use disorder (OUD) are under-utilized among adolescents and young adults ("youth"). Offering buprenorphine or naltrexone in primary care settings may reduce barriers to their use among youth. We conducted a secondary, patient-level analysis of the PROUD cluster-randomized clinical trial, which tested the implementation of a nurse care management intervention to support prescribing OUD medications.
View Article and Find Full Text PDFNat Med
July 2025
The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
We investigated the potential role of the opioid system in modulating glutamatergic effects of ketamine administration in major depressive disorder. Twenty-six adults with major depressive disorder participated in a double-blind crossover study, receiving oral placebo or 50 mg naltrexone before an intravenous infusion of 0.5 mg per kg ketamine.
View Article and Find Full Text PDF