ArticleBritish journal of pharmacology2020
Fentanyl depression of respiration: Comparison with heroin and morphine.
Article in British journal of pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
120 citing papers in PubMed, 1 synthesis or guideline pooled it, 203 citations in OpenAlex.
- Precipitants and clinical features of serotonin syndrome: a systematic review with patient-level analysis of published case reports and series.European journal of clinical pharmacology · 2026Pooled it
- Respiratory depression in women receiving propofol/esketamine versus propofol/fentanyl for abortion surgery or curettage: a randomized clinical trial.Annals of medicine · 2025Trial
- Opioidergic modulation of monetary incentive delay fMRI responses.Psychopharmacology · 2025Trial
- Effects of opioids and stimulants on the respiratory system.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Preclinical pharmacology of N-pyrrolidino "nitazene" opioids appearing in nonmedical drug markets.The Journal of pharmacology and experimental therapeutics · 2026Article
- Voluntary oral fentanyl intake produces dose- and sex-dependent physical dependence in mice without overt affective disturbances.bioRxiv : the preprint server for biology · 2026Article
- Opioid-specific risk of respiratory depression in non-cancer pain: a retrospective cohort study.BMC medicine · 2026Article
- Evaluation of Intravenous Lipid Emulsion as an Adjunctive Antidote in Experimental Fentanyl Toxicity: Comparison with Naloxone in a Rat Model.International journal of molecular sciences · 2026Article
- Fentanyl decreases arterial blood oxygen saturation more than furanylfentanyl in mice due to increased apnea.Psychopharmacology · 2026Article
- Dermorphin blocks apneic response to intravenous bolus injection of fentanyl.Toxicology and applied pharmacology · 2026Article
- A mu-opioid receptor positive allosteric modulator provides opioid-sparing antinociception without enhancing opioid side effects.The Journal of pharmacology and experimental therapeutics · 2026Article
- Analysis of rapid onset heroin overdose cases from a supervised injecting facility in Melbourne, Australia.Addiction (Abingdon, England) · 2026Article
- Acute fentanyl and xylazine co-exposure uniquely increase the excitability of dopamine type 2 receptor-expressing striatal medium spiny neurons.Journal of neurophysiology · 2026Article
- Fentanyl decreases blood oxygen more than furanylfentanyl despite similar effects on breathing.Research square · 2026Article
- The Role of Danavorexton for Perioperative Opioid-Induced Respiratory Depression and Sedation: A Narrative Review.Clinical pharmacology : advances and applications · 2026Review
- Overdose-Related Cardiac Arrest in the Era of the Opioid Epidemic.Critical care clinics · 2026Review
- Transcriptional response to chronic long-access fentanyl self-administration in rat habenula and amygdala.bioRxiv : the preprint server for biology · 2025Article
- Comparison of ventilatory depression by carfentanil, fentanyl, and heroin, and reversal by opioid receptor antagonists in rats.Neuropharmacology · 2025Article
- Design, Syntheses, and Pharmacological Evaluations of Core Ring Expanded Fentanyl Analogues as Potential Counteracting Agents Against Fentanyl Induced Respiratory Depression.Journal of medicinal chemistry · 2025Article
- Combining the alpha-2 adrenergic agonist clonidine with naloxone rescues fentanyl-induced physiologic dysfunction and increases survival.bioRxiv : the preprint server for biology · 2025Article
60 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
background and purposeFentanyl overdose deaths have reached "epidemic" levels in North America. Death in opioid overdose invariably results from respiratory depression. In the present work, we have characterized how fentanyl depresses respiration, and by comparing fentanyl with heroin and morphine, the active breakdown product of heroin, we have sought to determine the factors, in addition to high potency, that contribute to the lethality of fentanyl. EXPERIMENTAL APPROACH: Respiration (rate and tidal volume) was measured in awake, freely moving mice by whole body plethysmography. KEY
resultsIntravenously administered fentanyl produced more rapid depression of respiration than equipotent doses of heroin or morphine. Fentanyl depressed both respiratory rate and tidal volume. Fentanyl did not depress respiration in μ-opioid receptor knockout mice. Naloxone, the opioid antagonist widely used to treat opioid overdose, reversed the depression of respiration by morphine more readily than that by fentanyl, whereas diprenorphine, a more lipophilic antagonist, was equipotent in reversing fentanyl and morphine depression of respiration. Prolonged treatment with morphine induced tolerance to respiratory depression, but the degree of cross tolerance to fentanyl was less than the tolerance to morphine itself. CONCLUSION AND IMPLICATIONS: We propose that several factors (potency, rate of onset, lowered sensitivity to naloxone, and lowered cross tolerance to heroin) combine to make fentanyl more likely to cause opioid overdose deaths than other commonly abused opioids. Lipophilic antagonists such as diprenorphine may be better antidotes than naloxone to treat fentanyl overdose.
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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.