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Am J Psychiatry 1994; 151:1463-1467
Copyright © 1994 by American Psychiatric Association
Naltrexone-induced alterations in human ethanol intoxication
RM Swift, W Whelihan, O Kuznetsov, G Buongiorno and H Hsuing
Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI.
OBJECTIVE: Outpatient clinical trials with an opioid antagonist,
naltrexone, found that this agent reduces relapse drinking in abstinent
alcoholics. It is unknown which aspects of intoxication may be affected by
naltrexone. The authors investigated the effects of naltrexone on several
subjective and objective measures of ethanol intoxication. METHOD: In a
double-blind crossover study, 19 nonalcoholic drinkers received a regimen
of naltrexone, 50 mg p.o., or placebo on two different occasions, each time
followed by a standard, intoxicating dose of ethanol. Subjective and
objective measures of intoxication including mood, physical sensations,
performance changes, and ethanol pharmacokinetics were determined. As a
control for naltrexone effects, 12 additional subjects received naltrexone
or placebo followed by a non- intoxicating, "placebo" dose of ethanol.
RESULTS: Naltrexone augmented certain sedative and discriminant effects of
ethanol and reduced positive reinforcing effects without affecting
psychomotor performance or ethanol pharmacokinetics. Naltrexone had minimal
effects in subjects receiving placebo ethanol. CONCLUSIONS: The data are
compatible with the clinical findings and suggest that the reduction in
ethanol consumption by alcoholics following naltrexone administration may
occur because of greater subjective intoxication, greater aversive effects,
or less positive reinforcement from ethanol.
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