CoChat
Sign Up
Cited by 64Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPain Management and Opioid Use

Anxiety, Depression, and Insomnia Among Adults With Opioid Dependence Treated With Extended-Release Naltrexone vs Buprenorphine-Naloxone: A Randomized Clinical Trial and Follow-up Study

Open access
Latif, Zill-e-Huma, Šaltyte Benth, Jurate, Solli, Kristin Klemmetsby, Opheim, Arild, Kunoe, Nikolaj, Krajci, Peter, Sharma-Haase, Kamni, Tanum, Lars·2019·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2018.3537PMC PMC6439739
Open this paper in CoChat — free accountOpen PDF

Abstract

Importance: Extended-release naltrexone (XR-NTX) is a promising alternative treatment of opioid addiction but has never been compared with opioid agonist treatment for effects on symptoms of anxiety, depression, and insomnia. Objective: To investigate whether XR-NTX unmasks or reinforces current comorbid symptoms of anxiety, depression, or insomnia compared with opioid agonist treatment. Design, Setting, and Participants: In this prospective randomized clinical trial, 159 men and women aged 18 to 60 years with opioid dependence were randomized to 12 weeks of treatment with either XR-NTX or combined buprenorphine-naloxone (BP-NLX) followed by a 9-month, open-label treatment study with participant choice of 1 of these 2 drugs. The study was conducted at outpatient addiction clinics in 5 urban hospitals in Norway, with the clinical trial performed from November 1, 2012, to October 23, 2015, and the follow-up study completed on July 23, 2016. All analyses were conducted using an intention-to-treat sample. Interventions: Extended-release naltrexone hydrochloride, 380 mg, administered as an injection every 4 weeks or flexible doses (4-24 mg; target dosage 16 mg/d) of daily oral combined BP-NLX. Main Outcomes and Measures: Every 4 weeks, symptoms of anxiety and depression were assessed using the 25-item Hopkins Symptom Checklist, and symptoms of insomnia were assessed using the Insomnia Severity Index. Results: In total, 159 participants were randomized to treatment with either XR-NTX (n = 80) or BP-NLX (n = 79), and 105 participants (66.0%) completed the trial. The treatment groups showed similar distributions of age (mean [SD], 36.4 [8.8] vs 35.7 [8.5] years), sex (61 [76.3%] women and 54 [68.4%] men), and duration of heroin use (mean [SD], 6.9 [5.8] vs 6.7 [5.2] years). For the clinical trial period, no overall differences were detected between treatment groups for anxiety (effect size [95% CI], -0.14 [-0.47 to 0.19]) or depression (effect size [95% CI], -0.12 [-0.45 to 0.21]) scores, but the insomnia score was significantly lower in the XR-NTX group (effect size [95% CI], -0.32 [-0.61 to -0.02]; P = .008). In the follow-up period, no overall differences could be detected in the effect size [95% CI] of scores for anxiety (0.04 [-0.34 to 0.42]), depression (-0.04 [-0.42 to 0.33]), or insomnia (0.04 [-0.33 to 0.42]) between participants continuing with and participants switching to XR-NTX. No significant sex differences between the 2 treatment groups were detected. Conclusions and Relevance: Comorbid symptoms of anxiety, depression, or insomnia in abstinence-motivated persons with opioid dependence should not prevent switching from treatment with an opioid agonist to treatment with XR-NTX. Trial Registration: ClinicalTrials.gov Identifier: NCT01717963.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2018.3537

Cites

52 of 52 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Buprenorphine shows antidepressant effects in both opioid use disorder and treatment-resistant depression.

    “Buprenorphine has antidepressant effects when used for both opioid use disorder and treatment-resistant depression (279-284)”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [284]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 54 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Hesbacher PT, Rickels K, Morris RJ, Newman H, Rosenfeld H. Psychiatric illness in family practice. J Clin Psychiatry. 1980;41(1):6-10.

Cited by

Sorted by citations

Related

Authors
Latif, Z.-E.-H., Šaltyte Benth, J., Solli, K. K., Opheim, A., Kunoe, N., Krajci, P., Sharma-Haase, K., & Tanum, L.
Affiliations
  • University of Oslo (NO)
  • Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
  • Haukeland University Hospital (NO)
  • Department of Research and Development in Mental Health, Akershus University Hospital, Lørenskog, Norway
  • Department of Addiction Medicine, Oslo University Hospital, Oslo, Norway
  • Norwegian Center for Addiction Research, University of Oslo, Oslo, Norway
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2019-02-01
Volume
76
Issue
2
Pages
127
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2018.3537
PMC
PMC6439739
OpenAlex
W2903979630
Cited by
64
References
54
Citations by year
2026: 6 · 2025: 10 · 2024: 5 · 2023: 7 · 2022: 11 · 2021: 15 · 2020: 7 · 2019: 3
FWCI
5.95
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
Funders
Norges Forskningsråd
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
opioid use disorder, extended-release naltrexone, buprenorphine/naloxone, opioid substitution therapy, opioid antagonists, anxiety, depression, insomnia, comorbid psychiatric symptoms, heroin use, relapse, opioid use disorder treatment
MeSH terms
Buprenorphine, Naloxone Drug Combination, Administration, Oral, Adolescent, Adult, Anxiety, Delayed-Action Preparations, Depression, Female, Follow-Up Studies, Humans, Injections, Intramuscular, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Naltrexone, Opioid-Related Disorders, Comorbidity, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review