Am J Psychiatry 1986; 143:831-837
Copyright © 1986 by American Psychiatric Association
The combined use of clonidine and naltrexone as a rapid, safe, and effective treatment of abrupt withdrawal from methadone
DS Charney, GR Heninger and HD Kleber
Combined clonidine and naltrexone treatment allowed 38 of 40 patients
addicted to methadone to withdraw completely in 4-5 days. For most patients
naltrexone was gradually increased from 1 mg/day to 50 mg/day over 4 days.
Clonidine reduced the intensity of naltrexone-induced withdrawal symptoms.
Clonidine significantly decreased blood pressure without producing syncope
and caused sedation but no other clinical problems. The withdrawal symptoms
of anxiety, anorexia, insomnia, restlessness, and muscular aching were most
resistant but were mild or nonexistent at discharge. Clonidine-naltrexone
treatment should succeed with patients receiving methadone doses up to 50
mg/day, facilitate naltrexone maintenance, and apply to many clinical
settings.
