SynthesisAddiction (Abingdon, England)2002
Alpha2-adrenergic agonists in opioid withdrawal.
Synthesis in Addiction (Abingdon, England), 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 69 citations in OpenAlex.
- Gabapentin and D-cycloserine alone and in combination with naloxone in methadone-maintained humans responding under a naloxone novel-response discrimination procedure.Behavioural pharmacology · 2025Trial
- Effects of prototypic calcium channel blockers in methadone-maintained humans responding under a naloxone discrimination procedure.European journal of pharmacology · 2013Trial
- Randomized, placebo-controlled pilot trial of gabapentin during an outpatient, buprenorphine-assisted detoxification procedure.Experimental and clinical psychopharmacology · 2013Trial
- [Clonidine for remifentanil-induced hyperalgesia: a double-blind randomized, placebo-controlled study of clonidine under intra-operative use of remifentanil in elective surgery of the shoulder].Schmerz (Berlin, Germany) · 2011Trial
- A Phase 3 placebo-controlled, double-blind, multi-site trial of the alpha-2-adrenergic agonist, lofexidine, for opioid withdrawal.Drug and alcohol dependence · 2008Trial
- Effect of selective serotonin reuptake inhibitor discontinuation on anxiety-like behaviours in mice.Journal of psychopharmacology (Oxford, England) · 2022Article
- Feasibility and Preliminary Efficacy of Isradipine During Outpatient Buprenorphine Stabilization and Detoxification: A Pilot Randomized, Placebo-Controlled Trial.Substance abuse : research and treatment · 2020Article
- Is it prime time for alpha2-adrenocepter agonists in the treatment of withdrawal syndromes?Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2014Review
- Opioid induced hyperalgesia in anesthetic settings.Korean journal of anesthesiology · 2014Review
- Differential effects of acute and chronic treatment with the α2-adrenergic agonist, lofexidine, on cocaine self-administration in rhesus monkeys.Drug and alcohol dependence · 2013Article
- Risk of serious cardiovascular problems with medications for attention-deficit hyperactivity disorder.CNS drugs · 2013Review
- Influence of clonidine and ketamine on m-RNA expression in a model of opioid-induced hyperalgesia in mice.PloS one · 2013Article
- Some effects of dopamine transporter and receptor ligands on discriminative stimulus, physiologic, and directly observable indices of opioid withdrawal in rhesus monkeys.Psychopharmacology · 2009Article
- Functional neuroanatomy of the noradrenergic locus coeruleus: its roles in the regulation of arousal and autonomic function part II: physiological and pharmacological manipulations and pathological alterations of locus coeruleus activity in humans.Current neuropharmacology · 2008Article
- [Opioid-induced analgesia and hyperalgesia].Schmerz (Berlin, Germany) · 2005Article
- Jail management of arrestees/inmates enrolled in community methadone maintenance programs.Journal of urban health : bulletin of the New York Academy of Medicine · 2004Article
- [Opioid-induced hyperalgesia. Pathophysiology and clinical relevance].Der Anaesthesist · 2004Review
- Efficacy of buprenorphine and clonidine in opioid detoxification: A hospital- based study.Indian journal of psychiatryArticle
- A comparison of the efficacy of buprenorphine and clonidine in detoxification of heroin-dependents and the following maintenance treatment.Addiction & healthArticle
Corrections and comments
- Commented on by
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis paper presents the main findings of a systematic (Cochrane) review of the effectiveness of alpha2-adrenergic agonists in managing opioid withdrawal.
designThe original systematic review included controlled trials that compared alpha2-adrenergic agonists with another form of treatment (or placebo) in participants who were primarily opioid-dependent. MAIN
findingsTen studies compared a treatment regime based on an alpha2-adrenergic agonist with one based on reducing doses of methadone. Withdrawal intensity is similar to, or marginally greater with alpha2-adrenergic agonists, but signs and symptoms of withdrawal occur and resolve earlier in treatment. Participants stay in treatment longer with methadone. The likelihood of completing withdrawal is similar, or slightly less, with clonidine or lofexidine. Clonidine is associated with more adverse effects than reducing doses of methadone. Three studies compared the alpha2-adrenergic agonists, clonidine and lofexidine. Lofexidine does not reduce blood pressure to the same extent as clonidine, but is otherwise similar to clonidine.
conclusionsParticipants stay in treatment longer with methadone regimes, which may provide greater opportunity for psychosocial intervention. Methadone regimes may be preferable for withdrawal in outpatient settings where the risk of relapse to heroin use is high. The use of methadone may also facilitate transfer to maintenance treatment should completion of withdrawal become unlikely. For those who are well prepared for withdrawal and seeking earlier resolution of withdrawal symptoms, alpha2-adrenergic agonist treatment may be preferred. Clonidine and lofexidine appear equally effective for inpatient settings, but the lower incidence of hypotension makes lofexidine more suited to use in outpatient settings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.