Naltrexone long-acting formulation in the treatment of alcohol dependence

Figures & data

Table 1 Advantages and disadvantages of depot naltrexone preparations compared with oral naltrexone in alcohol-dependent individuals

Advantages of depot naltrexone preparations compared with oral naltrexone

Disadvantages of depot naltrexone preparations compared with oral naltrexone

Efficacy is not compromised since there are not significant fluctuations in plasma levels causing low trough levels Adverse events, particularly nausea, are not increased by high peak levels that would result from the plasma level fluctuations Since injections are spaced 4-weeks apart, problems with compliance are minimized The simplicity of supervision and administration might make the depot formulations suitable for forensic settings Patients who will be in situations where oral naltrexone is unavailable can receive treatment

An apparent gender disparity in efficacy (with men receiving the greater benefit) requires further exploration Certain adverse events, such as erythema, induration, and injection site reactions, are unique to the depot formulations Vivitrol^® is contraindicated in patients receiving opioid analgesics More health care providers must be involved to ensure proper administration Depot formulations could be cost prohibitive for many patients Delivery of psychosocial support might be needed more often than the monthly injections