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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.
Acknowledgements
The author thanks the National Institute on Alcohol Abuse and Alcoholism for its support through grants 7 U10 AA011776-10, 5 R01 AA014628-03, 5 R01 AA013964-03, 5 R01 AA012964-06, and 7 R01 AA010522-12; the National Institutes of Health for its support through University of Virginia General Clinical Research Center Grant M01 RR00847; the staff at the University of Virginia Center for Addiction Research and Education (CARE), and Robert H. Cormier, Jr. for his assistance with manuscript preparation.