Effectiveness of naltrexone in the prevention of delayed respiratory arrest in opioid-naive methadone-intoxicated patients

Aghabiklooei, A. and Hassanian-Moghaddam, H. and Zamani, N. and Shadnia, S. and Mashayekhian, M. and Rahimi, M. and Nasouhi, S. and Ghoochani, A. (2013) Effectiveness of naltrexone in the prevention of delayed respiratory arrest in opioid-naive methadone-intoxicated patients. BioMed Research International, 2013.


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Acute methadone toxicity is a major public health concern in Iran. Methadone-intoxicated patients are in a great risk of recurrent or delayed respiratory arrest despite the prescription of initial doses of naloxone. This study aimed to evaluate the effectiveness of oral naltrexone in the management of acute methadone overdose in opioid-naive patients and check if it could be a substitute of continuous infusion of naloxone in maintaining adequate ventilation. In a randomized, double-blind, placebo-controlled study, a total of 54 opioid-naive patients with acute methadone toxicity were enrolled. The patients received either oral naltrexone or placebo capsules after awakening by naloxone. All patients underwent close monitoring of respiration. Frequency of respiratory depression or arrest, need for another dose of naloxone, duration of hospital stay, and adverse outcomes compared between the two groups. The incidence of respiratory depression was significantly less in those who had received naltrexone. Our results show that single oral dose of naltrexone is quite efficient in the prevention of recurrent or delayed respiratory arrest in opioid-naive methadone-intoxicated patients. It can shorten the duration of hospitalization and, as a consequence, decreased the risk of complications. Further studies are warranted before the generalization of this approach to other patient populations. © 2013 Abbas Aghabiklooei et al.

Item Type: Article
Additional Information: cited By 9
Uncontrolled Keywords: methadone; naltrexone; placebo; methadone; naltrexone; narcotic analgesic agent, adult; apnea; article; bradypnea; continuous infusion; controlled study; dizziness; double blind procedure; drug efficacy; drug intoxication; electrocardiography; falling; female; hospitalization; human; major clinical study; male; nausea and vomiting; patient monitoring; pruritus; randomized controlled trial; respiratory arrest; seizure; single drug dose; weakness; adolescent; breathing disorder; chemically induced disorder; controlled clinical trial; Iran; young adult, Adolescent; Adult; Analgesics, Opioid; Double-Blind Method; Female; Humans; Iran; Male; Methadone; Naltrexone; Respiration Disorders; Young Adult
Subjects: QV Pharmacology
Depositing User: somayeh pourmorteza
Date Deposited: 01 Jun 2019 05:08
Last Modified: 01 Jun 2019 05:08
URI: http://eprints.iums.ac.ir/id/eprint/9581

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