Which of the following drugs is not used in opioid dependence
Correct Answer: Disulfiram
Description: Use of substitution drugs such as methadone (not available in India at present) to ameliorate the withdrawal symptoms. The aim is to gradually taper off the patient from methadone (which is less addicting, has a longer half-life, decreases possible criminal behaviour, and has a much milder withdrawal syndrome). Naltrexone is an orally available narcotic antagonist which, when given to an opioid-dependent individual, causes withdrawal symptoms. These symptoms are managed with the addition of clonidine for 10-14 days after which clonidine is withdrawn and the patient has continued on naltrexone alone. Now if the person takes an opioid, there are no pleasurable experiences, as the opioid receptors are blocked by naltrexone. Therefore, this method is a combination of detoxification and maintenance treatment. The usual dose of naltrexone is 100 mg orally, administered on alternate days. Once again treatment is usually staed in an inpatient psychiatric or specialist alcohol and drug treatment centre setting. Other Drugs: The other detoxification agents include LAAM ( Levo-alpha-acetyl-Methadol), propoxyphene, diphenoxylate, buprenorphine (long-acting synthetic paial m-agonist which can be administered sublingually), and lofexidine (a2 agonist, similar to clonidine). Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 44
Category:
Psychiatry
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