Trial reportDrug and alcohol dependence2013
Naltrexone with or without guanfacine for preventing relapse to opiate addiction in St.-Petersburg, Russia.
Trial report in Drug and alcohol dependence, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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
21 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Substance Use Disorder Treatment Outcomes: Methodological Overview of Metrics and Criteria.International journal of methods in psychiatric research · 2025Pooled it
- Pooled it
- Pooled it
- Retention in medication-assisted treatment for opiate dependence: A systematic review.Journal of addictive diseases · 2016Pooled it
- Effects of lorcaserin on oxycodone self-administration and subjective responses in participants with opioid use disorder.Drug and alcohol dependence · 2020Trial
- Opioid use and dropout from extended-release naltrexone in a controlled trial: implications for mechanism.Addiction (Abingdon, England) · 2020Trial
- Psychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia.Drug and alcohol dependence · 2017Trial
- The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers.Drug and alcohol dependence · 2014Trial
- A Review of Alpha-2 Adrenergic Agents Implicated in Opioid Use Disorder.ACS chemical neuroscience · 2026Review
- The Effects of Chronic Naltrexone on Reinstatement of Opioid-Induced Drug-Seeking Behavior and Antinociception.The Journal of pharmacology and experimental therapeutics · 2024Article
- An ensemble recruited by αNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Consideration of sex as a biological variable in the translation of pharmacotherapy for stress-associated drug seeking.Neurobiology of stress · 2021Review
- αNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2020Article
- Anti-stress neuropharmacological mechanisms and targets for addiction treatment: A translational framework.Neurobiology of stress · 2018Review
- The Policy-Driven HIV Epidemic Among Opioid Users in the Russian Federation.Current HIV/AIDS reports · 2018Review
- Medication Treatment for Opioid Use Disorders:: A Brief Overview with Comments on Extended Release Naltrexone.Delaware journal of public health · 2017Article
- Implementation of methadone therapy for opioid use disorder in Russia - a modeled cost-effectiveness analysis.Substance abuse treatment, prevention, and policy · 2017Article
- Alcohol and Opioid Use Disorder in Older Adults: Neglected and Treatable Illnesses.Current psychiatry reports · 2016Review
- Neurobiology of opioid dependence in creating addiction vulnerability.F1000Research · 2016Review
- Stress-Induced Reinstatement of Drug Seeking: 20 Years of Progress.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundStress is a key precipitant to discontinuing naltrexone and relapsing to opiate abuse. Alpha-2 adrenergic agonists like guanfacine may reduce stress induced craving and have reduced opiate relapse in small clinical trials.
methodsThis randomized, double blind double dummy placebo-controlled 6-month trial tested oral naltrexone with or without guanfacine for reducing stress and preventing opiate relapse. We randomized 301 patients to: naltrexone 50 mg/day+guanfacine 1 mg/day (n=75) (N/G), naltrexone+guanfacine placebo (N/P) (n=76), naltrexone placebo+guanfacine (n=75) (P/G), and double placebo (n=75) (P/P).
resultsAmong the 75 patients in each group the percentage still retained on naltrexone treatment at six months was: N/G 26.7%, N/P 19.7% (p=0.258 to N/G), P/G 6.7% (p<0.05 to both N groups), and P/P 10.7% (p=0.013 to N+G). Guanfacine reduced the severity of stress particularly at weeks 10 and 18. Adverse events (AE) were infrequent (4.7%) without group differences, with most common AEs: headache, poor appetite, insomnia, and dizziness.
conclusionsAdding guanfacine to naltrexone did not improve treatment retention or opiate free urines, but it reduced both stress and craving at later time points in treatment, which may be related to stress-induced craving and the animal model of incubation of reinstatement. During treatment, HIV risk, anxiety, and depression reduced among all patients in treatment, regardless of group.
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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.