Clonidine blocks acute opiate-withdrawal symptoms
Abstract
In a double-blind, placebo-controlled, cross-over trial, clonidine eliminated objective signs and subjective symptoms of opiate withdrawal for 240--360 min in eleven addicts in a hospital setting. In an open pilot study of the effects of clonidine on longer-term opiate abstinence and symptoms, the same patients did well while taking clonidine for one week. There was only one documented instance of heroin use, in a patient who did not take clonidine after hospital discharge. 6 weeks or more after the study, four patients were back on reduced doses of methadone, one was on tricyclic antidepressants, and seven were off of all opiates. All eleven patients were doing well. These data suggest that opiate withdrawal is due to increased neuronal activity in areas such as the locus coeruleus which are regulated by both alpha-2 adrenergic and opiate receptors.
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Norepinephrine activation has long been hypothesized to be involved in opioid withdrawal in animals and in humans.
“Norepinephrine activation has long been hypothesized to be involved in opioid withdrawal in animals, based on neurobiological measures and the pharmacology of withdrawal (Maldonado, 1997), and in humans, based largely on pharmacological studies of opioid withdrawal (Gold et al., 1978;Harris and Gewirtz, 2005).”
From Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development (2021) · cites this paper as Gold et al., 1978
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Self-citation
- Authors
- Gold, M., Redmond, D. E., & Kleber, H.
- Affiliations
- Yale University (US)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1978-09
- Volume
- 312
- Issue
- 8090
- Pages
- 599-602
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2097329845
- Cited by
- 710
- References
- 23
- Citations by year
- 2026: 7 · 2024: 6 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 10 · 2019: 4 · 2018: 12 · 2017: 5 · 2016: 9 · 2015: 5 · 2014: 14 · 2013: 7 · 2012: 9
- FWCI
- 57.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- 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
- clonidine, opioid withdrawal, heroin addiction, opioid use disorder, alpha2-adrenoceptors, locus coeruleus, methadone, tricyclic antidepressants, withdrawal symptoms
- MeSH terms
- Acute Disease, Clinical Trials as Topic, Clonidine, Double-Blind Method, Drug Evaluation, Follow-Up Studies, Humans, Methadone, Nursing Assessment, Patient Compliance, Placebos, Self-Assessment, Substance Withdrawal Syndrome, Time Factors, Substance-Related Disorders
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