Literature DB >> 23714324

Effects of the opioid receptor antagonist naltrexone on smoking and related behaviors in smokers preparing to quit: a randomized controlled trial.

Andrea King1, Dingcai Cao, Lingjiao Zhang, Sandra Yu Rueger.   

Abstract

AIMS: To determine if naltrexone affects smoking behaviors in smokers preparing to quit, and whether or not such pre-quit responses predict post-quit date outcomes.
DESIGN: Double-blind, placebo-controlled, randomized study. The current study focused on smoking-related outcomes in the pre-quit phase, which was 1 week prior to the quit date, and these findings were linked with reductions in the same outcomes demonstrated in the post-quit phase published previously for this randomized controlled trial (RCT) in mediation analyses.
SETTING: Community sample of adult smokers desiring to quit in Chicago, Illinois, USA. PARTICIPANTS: Participants were 315 smokers randomized to naltrexone (n = 161; mean age = 42.58 years; 60% Caucasian) or placebo (n = 154; mean age = 41.32 years; 55% Caucasian). MEASUREMENTS: The difference from baseline in the number of cigarettes smoked during the pre-quit phase interval was the primary outcome. Secondary pre-quit outcomes were assessed using Likert scales of subjective responses and consumption of cigarettes, alcohol and food. Number of cigarettes smoked, alcoholic drinks consumed and the Brief Questionnaire of Smoking Urges were assessed in the post-quit phase.
FINDINGS: Relative to placebo, naltrexone decreased the number of cigarettes smoked (-4.21 versus -2.93, P < 0.05), smoking urge (P = 0.02) and number of alcoholic drinks consumed (P = 0.04). Exploratory mediation analyses linking outcomes of the pre-quit and post-quit phases found that naltrexone's effects on reducing smoking urge, cigarettes smoked and alcoholic drinks consumed in the pre-quit phase demonstrated full mediation of their respective effects during the post-quit phase.
CONCLUSIONS: Naltrexone taken in the week before a quit attempt reduces cigarette consumption, urges to smoke and alcohol consumption relative to placebo. The size of the effect mediates statistically the size of similar effects after the quit date.
© 2013 Society for the Study of Addiction.

Entities:  

Keywords:  Alcohol; cigarette smoking; cotinine; naltrexone; opioid antagonist; smoking urge

Mesh:

Substances:

Year:  2013        PMID: 23714324      PMCID: PMC3775903          DOI: 10.1111/add.12261

Source DB:  PubMed          Journal:  Addiction        ISSN: 0965-2140            Impact factor:   6.526


  48 in total

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Review 2.  Opioid antagonists for smoking cessation.

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3.  A controlled trial of naltrexone augmentation of nicotine replacement therapy for smoking cessation.

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Journal:  Arch Intern Med       Date:  2006-03-27

Review 4.  Targeting treatments for alcohol dependence: the pharmacogenetics of naltrexone.

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Journal:  Addict Biol       Date:  2006-09       Impact factor: 4.280

5.  Changes of smoking behavior and serum adrenocorticotropic hormone, cortisol, prolactin, and endogenous opioids levels in nicotine dependence after naltrexone treatment.

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6.  Naltrexone effects on short-term and long-term smoking cessation.

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7.  Naltrexone augments the effects of nicotine replacement therapy in female smokers.

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8.  Naloxone challenge in smokers. Preliminary evidence of an opioid component in nicotine dependence.

Authors:  S Krishnan-Sarin; M I Rosen; S S O'Malley
Journal:  Arch Gen Psychiatry       Date:  1999-07

9.  Effects of naltrexone with nicotine replacement on smoking cue reactivity: preliminary results.

Authors:  K E Hutchison; P M Monti; D J Rohsenow; R M Swift; S M Colby; M Gnys; R S Niaura; A D Sirota
Journal:  Psychopharmacology (Berl)       Date:  1999-02       Impact factor: 4.530

10.  Efficacy of naltrexone in smoking cessation: a preliminary study and an examination of sex differences.

Authors:  Andrea King; Harriet de Wit; Roslynn C Riley; Dingcai Cao; Raymond Niaura; Dorothy Hatsukami
Journal:  Nicotine Tob Res       Date:  2006-10       Impact factor: 4.244

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3.  Naltrexone improves quit rates, attenuates smoking urge, and reduces alcohol use in heavy drinking smokers attempting to quit smoking.

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Review 4.  Endogenous opioid system: a promising target for future smoking cessation medications.

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Review 5.  Pharmacological Options for Smoking Cessation in Heavy-Drinking Smokers.

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6.  Efficacy of Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction: A Randomized Clinical Trial.

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7.  Naltrexone and alcohol effects on craving for cigarettes in heavy drinking smokers.

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Review 8.  The effectiveness of naltrexone combined with current smoking cessation medication to attenuate post smoking cessation weight gain: a literature review.

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9.  A gene-by-sex interaction for nicotine reward: evidence from humanized mice and epidemiology.

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