Warnings: This medication is a combination of bupropion and naltrexone. Naltrexone decreases the probability of a return to any drinking and binge-drinking risk (Kranzler and Soyka, 2018). Naltrexone for alcohol-dependent patients. Baltieri D. A., Daro F. R., Ribeiro P. L., de Andrade A. G. (2008). Official answer by Drugs.com Key Points Dizziness, drowsiness, sedation and fainting have all been reported as possible side effects with naltrexone treatment. Medication-assisted treatment (MAT) combines medication with counseling, behavioral therapy, and other treatment options. Naltrexone (Vivitrol) may interact with certain medications or supplements. Guerzoni S., Pellesi L., Pini L. A., Caputo F. (2018). (2010). Study flow diagram of selected studies (PRISMA). Whitworth A. Symptoms and Guide to Recovery. These side effects may go away during treatment as your body adjusts to the medicine. (1979). Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. Naltrexone Interactions. Prescribed sedative and other psychotropic medication use among clients attending alcohol and other drug treatment. More studies are required to establish the exact mechanisms of the opioid-induced effects on sleepwake cycle. Application of the inclusion and exclusion criteria resulted in 26 RCT on the efficacy and/or safety of disulfiram, acamprosate, naltrexone, and nalmefene. FOIA Contact your provider right away if you notice symptoms of liver injury, such as being overly tired, yellowing of the skin or whites of your eyes, severe pain on the right side of your stomach, or dark urine. This drug is the first and still the only pharmacological compound registered for reduced drinking in patients with alcohol dependence by the European Medicines Agency (EMA, 2010). Acamprosate supports abstinence by normalizing the often-protracted dysregulation of NMDA-mediated glutamatergic neurotransmission that follows chronic heavy alcohol use and withdrawal (Mason and Crean, 2007). One study was based in Iran (Ahmadi and Ahmadi, 2002), two studies in the US (Anton et al., 1999; Kranzler et al., 2000), one in Brazil (Baltieri et al., 2008), and one in Germany (Gastpar et al., 2002; multicentric). Naltrexone is a prescription medication used to treat alcohol use disorder and opioid use disorder. Although these drugs show lower dependence than benzodiazepines, there is still concern over the non-negligible potential of abuse of the Z hypnotics, which would be unsafe in people with history of drug addiction (Hajak et al., 2003), and could also interact with alcohol. - Uses, Side Effects, and More. 8600 Rockville Pike A growing body of literature highlights the importance of addressing sleep problems to support the treatment of AUD, especially during acute withdrawal. It is therefore suggested that sleep problems increase the risk for developing AUD (Teplin et al., 2006). The risk of selection bias was mainly unclear, as many studies failed to describe the randomization procedure, while only few studies did (Namkoong et al., 2003; Anton et al., 2006; Karhuvaara et al., 2007; Baltieri et al., 2008; OMalley et al., 2008; Perney et al., 2012; Mann et al., 2013), and almost none of the studies described the allocation concealment, except for Anton et al. Namkoong K., Lee B. O., Lee P. G., Choi M. J., Lee E. (2003). Excessive daytime sleepiness characterized by strong desire for sleep. These side effects may go away during treatment as your body adjusts to the medicine. Novel pharmacological interventions for alcoholism. It has many possible drug interactions, including some antidepressants, antibiotics, and diuretics. Last updated on Jan 12, 2023. Searches were limited to articles published in English. This systematic review with meta-analysis aims to determine how the pharmacotherapy for AUD impacts the quality of sleep. Naltrexone in the treatment of alcohol dependence. Naltrexone (Vivitrol) can cause withdrawal symptoms requiring hospitalization if a person is still dependent on opioid medications. Harris B. R., Prendergast M. A., Gibson D. A., Rogers D. T., Blanchard J. Can Naltrexone Treat Drug And Alcohol Addiction? . (2000); Kranzler et al. APA. Using the scores from the CASP checklist (CASP UK, 2019), the risk of bias for each domain was rated as: high (CASP: no), low (CASP: yes), or unclear (CASP: cant tell) in the Cochranes Review Manager (RevMan, 2014) (see Figure 4). Naltrexone as an adjunctive treatment for older patients with alcohol dependence. Nam H. W., Karpyak V. M., Hinton D. J., Geske J. R., Ho A. M., Prieto M. L., et al. (1981). Finally, similar trends for increased insomnia were observed with nalmefene, although much less evidence was available, and the statistical significance was null or not reported. In OUD, oral naltrexone tablets have not been shown to be more effective than placebo (an inactive pill) as patients do not consistently stay on treatment as prescribed. Drug-drug interactions in the treatment for alcohol use disorders: a comprehensive review, Noradrenaline and adrenaline in the rat brain during acute and chronic morphine administration and during withdrawal, The effects of antidepressants on sleep: a review. Throughout the CASP checklist, reviewers selected yes (score: 2) if the procedure (e.g., randomization) was cited and clearly described, no (score: 0) if the procedure was not cited, and cant tell (score: 1) if the procedure was only cited but not described. Miranda R., Ray L., Blanchard A., Reynolds E. K., Monti P. M., Chun T., et al. A., Manning V., Garfield J. Finally, the active marijuana- placebo naltrexone condition was compared . Action of ethanol and salsolinol on opiate receptor function. Be sure to contact your provider right away if you notice symptoms such as being overly tired, yellowing of the skin or whites of your eyes, severe pain on the right side of your stomach, or dark urine. It blocks opioid receptors (signaling proteins) in your body and prevents you from feeling the effects of opioid medications and alcohol. (1981). Naltrexone (Vivitrol) is used for treating opioid use disorder and alcohol use disorder. The list below does not include all possible drug interactions with naltrexone (Vivitrol). A 90-day placebo-controlled dose-finding study, Pelc I., Le Bon O., Verbanck P., Lehert P. N., Opsomer L. (1992). If there's a situation where you need pain medications (like a procedure or surgery), make sure to let your provider know that you've been taking naltrexone (Vivitrol). (2013). Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. Paxil is considered to be the most problematic. In fact, in all studies where sleep measures were reported as adverse effects, it was not possible to determine at what point in the study these were assessed and how was the sleep quality before the treatment, and this represents a potential bias for this review. See more incompatible drugs here. and transmitted securely. The rationale for the use of opioid receptor antagonists to treat alcohol dependence dates back to 1980s, when preclinical studies first showed an interaction between alcohol and opioid receptors, involving an important role for the endogenous opioid system as a mediator of the reinforcing effects of alcohol (Hiller et al., 1981). Worsening of sleep quality in AUD patients may increase the drive to use alcohol to self-medicate sleep problems, which, in turn, would further impair sleep in a dangerous vicious circle (Figure 2). Your treatment will need to be evaluated. These products are provided 'AS IS' and 'as available' for use, without warranties of any kind, either express or implied. If you become very drowsy with slowed breathing, this may be a sign that you are having an opioid overdose, which may lead to death, if you have taken opioids with naltrexone. Learn how you can achieve your weight loss goals without breaking your budget. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Does naltrexone (Vivitrol) make me feel sleepy? The typical dose for both alcohol and opioid use disorder is 380 mg injected into the muscles of the buttocks once a month. (2004); Kranzler et al. These drugs work in different ways and have fared differently in research studies. SSRIs, such as Zoloft ( sertraline ), may cause weight gain and can make. Effect of the threat of a disulfiram-ethanol reaction on cue reactivity in alcoholics. In fact, the complexity of AUD, especially from a neurobiological evaluation, makes pharmacologic treatments particularly difficult, considering the high co-morbidity with mood-related disorders (psychotic, bipolar, depressive, anxiety, sexual dysfunction, obsessive-compulsive, delirium, neurocognitive) and, in particular, with sleep disorders. With any medication, there are risks and benefits. Interestingly, disulfiram inhibits the production of noradrenaline by blocking the dopamine -hydroxylase enzyme (Goldstein et al., 1964), and this may underlie the decreased REM sleep. Opiates, cough medicines containing opioids, and diarrhea medications (like Lomotil) can interact with naltrexone. (2006), Gual et al. Reid L. D., Czirr S. A., Milano W. C., Hubbell C. L., Manha N. A. It is possible to have an allergic reaction from Vivitrol, including hives, angioedema (swelling under the skin), and even anaphylaxis (which can be life threatening). (2003); Snyder et al. Now Dr. Mehta and the Weill Cornell Medicine pain management team have begun using a safe, old drug in new waysand in low dosesto treat certain patients. Brower K. J., Aldrich M. S., Robinson E. A., Zucker R. A., Greden J. F. (2001). Some people have reported feeling depressed or having thoughts of self-harm while taking naltrexone (Vivitrol). Use of opioid antagonists appears to reduce certain aspects of alcohol drinking in animals (Hyytia and Sinclair, 1993) and in humans (Reid et al., 1986). Naltrexone (Vivitrol) is also available as an injection given by a healthcare provider. The research question was: how does the pharmacotherapy for AUD (disulfiram, acamprosate, naltrexone, and nalmefene) affect sleep? (2013) observed significant diminutions of alcohol intake with nalmefene versus placebo, and although this drug induces many side effects, it is overall well tolerated (van den Brink et al., 2015). Naltrexone (Vivitrol) carries a low risk for liver injury. Accessibility Inform your family you are taking naltrexone and to be aware of any mood changes you may experience. Furthermore, improving the quality of sleep may as well support other psychosocial interventions such as cognitive behavioral therapy for a higher therapeutic success. In line with these trends, in the only polysomnography study by Staner et al. What are the new treatment options for migraines? Is naltrexone (Vivitrol) the same as naloxone (Narcan)? Combining Naltrexone and alcohol can present certain issues, and experts claim that the use of Naltrexone ought to be used in tandem with abstinence. Mann K., Bladstrom A., Torup L., Gual A., van den Brink W. (2013). (2012). The amount of time from lights out to sleep onset. The use of the Truven Health products is at your sole risk. Call your doctor for medical advice about side effects. The majority of RCT (14 studies) were on naltrexone, and most of them were of good quality (CASP: 1417; Oslin et al., 1997; Anton et al., 1999; Kranzler et al., 2000; Heinala et al., 2001; Krystal et al., 2001; Gastpar et al., 2002; Johnson et al., 2004; Baltieri et al., 2008; Oslin et al., 2008; OMalley et al., 2008) while a few were of moderate quality (CASP: 1113; Ahmadi and Ahmadi, 2002; Kranzler et al., 2003; Ahmadi et al., 2004; Miranda et al., 2014). Plus, these treatments may be fake or unsafe. This may be a sign that you are experiencing a depressed mood. It must be considered that, since the outcome of interest of this review was not the pre-specified outcome of most studies, the relative level of risks of selective bias or other biases dont refer to the outcomes reviewed here. This is also known as opioid use disorder. Cronin A., Keifer J. C., Baghdoyan H. A., Lydic R. (1995). This is not all the information you need to know about naltrexone (Vivitrol) for safe and effective use. Nevertheless, sleep problems in AUD still remain often untreated, mainly for concerns about the safety of additional hypnotic drugs that can potentially induce dependence and can interfere with alcohol (Hajak et al., 2003; Ashton, 2005; Foulds et al., 2018). The treatment was naltrexone 50 mg/os/day and lasted for 12 weeks. Geerlings P. J., Ansoms C., van den Brink W. (1997). Kiefer F., Andersohn F., Otte C., Wolf K., Jahn H., Wiedemann K. (2004). Both authors discussed the results and reviewed the manuscript. Insomnia occurs in 3672% of alcoholic patients and may last for weeks to months during acute abstinence from alcohol (Brower, 2003). (2011). Yes, naltrexone (Vivitrol) can make you drowsy and dizzy. A sleep disorder in which someone sleeps for very long periods and is always very tired during the day. The articles included were appraised using the CASP checklists, and the risk of bias was assessed following the Cochrane risk-of-bias assessment tool. Suboxone (buprenorphine/naloxone) is a brand-name prescription drug used to treat dependence on opioid drugs. American Psychiatric Association, 1987, https://casp-uk.net/casp-tools-checklists/, www.ema.europa.eu/docs/enGB/document library/Scientific guideline/2010/03/WC500074898.pdf. Naltrexone is a medication that has been used to treat alcohol dependence and opioid-use disorder for more than 30 years. Background: Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence. Hajak G., Muller W. E., Wittchen H. U., Pittrow D., Kirch W. (2003). A double-blind, placebo-controlled study of oral nalmefene for alcohol dependence. Due to the paucity of information available, and with the majority of results being subjective, more research on this topic is needed to further inform the clinical practice, ideally with more objective measurements such as polysomnography. Be sure to tell them about any herbal products, vitamins or other OTC products you use. Naltrexone's intrinsic effects were assessed by comparing placebo and each active dose of naltrexone (12, 25, 50, and 100 mg) under the inactive marijuana condition (four comparisons). Alkermes. The two opioidergic drugs naltrexone and nalmefene had mainly detrimental effect on sleep, giving increased insomnia and/or somnolence compared with placebo, although not always significant. This systematic review aims to answer the question: how does the pharmacotherapy for AUD affect sleep? The disulfiram-induced reduction of REM sleep is quite interesting if we consider that during alcohol withdrawal, the REM sleep is usually increased (Brower, 2001). Don't operate a car or heavy machinery until you know how naltrexone (Vivitrol) affects you. Some tramadol interactions raise the risk of side effects of tramadol. Critical Appraisal Skills Programme (2019). Nalmefene gave more insomnia than placebo, although the significance was either null or not reported. ADH, alcohol dehydrogenase; ALDH, aldehyde dehydrogenase; MEOS, microsomal ethanol oxidizing system. A., Krol W. F., Kirk G. F., Rosenheck R. A., Veterans Affairs Naltrexone Cooperative Study 425 Group (2001). Side Effects. Each study is shown by a blue square that represents the odds ratio, with the horizontal lines being the 95% confidence intervals; the pooled Odds Ratio and 95% confidence interval by random-effect calculations are depicted as a diamond. (2016). (1999). An opioid addiction can be serious if untreated. A very upsetting or frightening dream/ an experience in which you see, hear, feel, or smell something that does not exist, usually because you are ill or have taken a drug. When you take naltrexone (Vivitrol) for opioid use disorder, your body becomes more sensitive to opioids. sleep problems ( insomnia ). These 5 Medications Can Help You Stop Drinking, Semaglutide: The First New FDA-Approved Weight Loss Medication Since 2014. Naltrexone and cognitive behavioral therapy for the treatment of outpatient alcoholics: results of a placebo-controlled trial. A sleeping giant: suvorexant for the treatment of alcohol use disorder. (2003). Be sure to speak up if you notice a change in your mood. Finally, due to the high level of methodological heterogeneity across the included studies, we estimated that it was not appropriate to pool the data in a meta-analysis. Overview Uses Dosage Side Effects Interactions Low-dose naltrexone therapy helps to relieve pain and fatigue associated with fibromyalgia and chronic fatigue syndrome . The amount of time awake after the onset of sleep and before final awakening. But it's also possible that this medication can make it more difficult for you to sleep. Thakkar M. M., Sharma R., Sahota P. (2015). Drugs & Medications Nucynta Nucynta - Uses, Side Effects, and More Generic Name (S): tapentadol View Free Coupon Warnings: Tapentadol has a risk for abuse and addiction, which can lead to. When you're being treated for opioid use disorder with naltrexone (Vivitrol), your body can become more sensitive to opioids. Results of a randomized, placebo-controlled, double-blind study in out-patient alcoholics in the Netherlands, Belgium and Luxembourg, Pharmacotherapy of most severe forms of alcohol withdrawal. Having little energy; feeling unwilling and unable to do anything. 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