Naltrexone
Naltrexone is an opioid antagonist that is approved for the treatment of both opioid
dependence and alcohol dependence.
Naltrexone for alcohol dependence
In people with alcohol dependence, it is believed that this blockade (opioid antagonism)
diminishes craving for alcohol and leads to a greater ability to resist urges to drink
excessively. Naltrexone is available in two forms: oral daily form (ReVia®, Depade®) and
injectable monthly extended-release form (Vivitrol®). The later was approved by FDA for
treatment of alcohol dependence in 2006.
Although the mechanism responsible for the reduction in alcohol consumption observed
with treatment is not entirely understood, preclinical data suggests that occupation
of the opioid receptors results in the blockade of the neurotransmitters in the
brain that are believed to be involved with alcohol dependence. This blockade may
result in the reduction in alcohol consumption observed in patients treated with
naltrexone.
Naltrexone for opioid dependence
Naltrexone is a non-opioid medication that is approved for the treatment of opioid dependence.
Naltrexone is an opioid receptor antagonist; it binds to opioid receptors, but instead of activating
the receptors, it effectively blocks them. Through this action, it prevents opioid receptors from
being activated by agonist compounds, such as heroin or prescription pain killers, and is reported to
reduce craving and prevent relapse. As opposed to other medications used for opioid dependence
(methadone and buprenorphine), naltrexone can be prescribed by any individual who is licensed to
prescribe medicine (e.g., physician, doctor of osteopathic medicine, physician assistant, and nurse
practitioner). Both the oral daily form and the monthly injectable monthly extended-release form (Vivitrol®)
are FDA approved for treatment of opioid dependence. Vivitrol® was approved by FDA for this
indication in 2010.
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