Am J Psychiatry 1991; 148:627-629
Copyright © 1991 by American Psychiatric Association
Comparison of acetorphan with clonidine for opiate withdrawal symptoms
F Hartmann, MF Poirier, MC Bourdel, H Loo, JM Lecomte and JC Schwartz
Service Hospitalo-Universitaire de Sante Mentale et de Therapeutique, Centre Hospitalier Sainte-Anne, Paris, France.
OBJECTIVE AND METHOD: The authors compared the effects of acetorphan, an
enkephalinase inhibitor, with those of clonidine for the treatment of the
opioid withdrawal syndrome. Nineteen patients addicted to heroin or
synthetic opiates who were undergoing drug withdrawal and displayed a
withdrawal syndrome according to DSM-III criteria were studied for 5 days
in a hospital setting. In a double-blind trial, 10 subjects were given
acetorphan intravenously and nine were given clonidine; objective signs and
subjective symptoms of withdrawal were recorded. RESULTS: On several
objective signs, the effect of acetorphan was more marked than that of
clonidine, whereas the two drugs exhibited similar efficacy with respect to
the subjective components of withdrawal. No side effect was noted in the
subjects who received acetorphan. CONCLUSIONS: Enkephalinase inhibition may
constitute a novel and safe therapeutic approach to the opioid withdrawal
syndrome.
