Brand names
Naltrexone is or has been sold under a variety of brand names, including Adepend, Antaxone, Celupan, Depade, Nalorex, Narcoral, Nemexin, Nodict, Revia, Trexan, Vivitrex, and Vivitrol. It is also marketed in combination with bupropion (naltrexone/bupropion) as Contrave, and was marketed with morphine (morphine/naltrexone) as Embeda. A combination of naltrexone with buprenorphine (buprenorphine/naltrexone) has been developed, but has not been marketed. Controversies
The FDA authorized use of injectable naltrexone (Vivitrol) for opioid addiction using a single study that was led by Evgeny Krupitsky at Bekhterev Research Psychoneurological Institute, St Petersburg State Pavlov Medical University, St Petersburg, Russia, a country where opioid agonists such as methadone and buprenorphine are not available. The study was a "double-blind, placebo-controlled, randomized", 24-week trial running "from July 3, 2008, through October 5, 2009" with "250 patients with opioid dependence disorder" at "13 clinical sites in Russia" on the use of injectable naltrexone (XR-NTX) for opioid dependence. The study was funded by the Boston-based biotech Alkermes firm which produces and markets naltrexone in the United States. Critics charged that the study violated ethical guidelines, since it compared the formulation of naltrexone not to the best available, evidence-based treatment (methadone or buprenorphine), but to a placebo. Further, the trial did not follow patients who dropped out of the trial to evaluate subsequent risk of fatal overdose, a major health concern .
Low-dose
"Low-dose naltrexone" (LDN) describes the off-label use of naltrexone at low doses for diseases not related to chemical dependency or intoxication, such as multiple sclerosis. Evidence for recommending such use is lacking. This treatment has received attention on the Internet. Self-injury
One study suggests that self-injurious behaviors present in persons with developmental disabilities (including autism) can sometimes be remedied with naltrexone. In these cases, the self-injury is believed to be done to release beta-endorphin, which binds to the same receptors as heroin and morphine. If the "rush" generated by self-injury is removed, the behavior may stop. Behavioral disorders
Some indications exist that naltrexone might be beneficial in the treatment of impulse-control disorders such as kleptomania, compulsive gambling, or trichotillomania (compulsive hair pulling), but evidence of its effectiveness for gambling is conflicting. A 2008 case study reported successful use of naltrexone in suppressing and treating an internet pornography addiction. Interferon alpha
Naltrexone is effective in suppressing the cytokine-mediated adverse neuropsychiatric effects of interferon alpha therapy. Critical addiction studies
Some historians and sociologists have suggested that the meanings and uses attributed to anti-craving medicine, such as naltrexone, is context-dependent. Studies have suggested the use of naltrexone in drug courts or healthcare rehabs is a form of "post-social control," or "post-disciplinary control," whereby control strategies for managing offenders and addicts shift from imprisonment and supervision toward more direct control over biological processes. Sexual addiction
Small studies have shown a reduction of sexual addiction and problematic sexual behaviours from naltrexone. References
External links
"Naltrexone". Drug Information Portal. U.S. National Library of Medicine.