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Naltrexone long-acting formulation in the treatment of alcohol dependence

Authors Bankole A Johnson

Published 15 November 2007 Volume 2007:3(5) Pages 741—749



Bankole A Johnson

Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA

Abstract: While oral naltrexone has a demonstrated ability to decrease alcohol reinforcement, it also has pharmacotherapeutic limitations, such as a small treatment effect size, adverse events, and plasma level fluctuations. The pharmacokinetic profile of naltrexone could be enhanced by intramuscular administration, which would sustain its release over several weeks and keep plasma levels relatively constant, ie, low enough to minimize side effects but high enough to reduce drinking. Vivitrex®/Vivitrol® and Naltrel® are injectable naltrexone depot formulations that have been tested as possible medications for treating alcohol dependence. Their adverse-event profiles appear to be less severe than that of oral naltrexone. Vivitrex®/Vivitrol® has demonstrated efficacy at decreasing heavy drinking among alcohol-dependent males. Naltrel® helped to promote abstinence and decrease the incidence of relapse in two samples of alcohol-dependent subjects. The data on a third formulation, Depotrex®, are still limited. All three formulations require further study of their efficacy.

Keywords: alcohol dependence, depot, Depotrex®, Naltrel®, naltrexone, Vivitrex®, Vivitrol®