Tennant F S, Rawson R A, Cohen A J, Mann A
J Clin Psychiatry. 1984 Sep;45(9 Pt 2):42-5.
In a study of 160 patients (including 114 active heroin addicts and 42 former heroin addicts maintained on methadone, propoxyphene napsylate, or LAAM), subjects were retained on treatment with naltrexone for a mean of 50.7 days (range, 1-635). Clonidine or guanabenz acetate was used to detoxify subjects who received naltrexone within 10 days of their last dose of opioid. Because of the number of subjects dropping out of treatment after only a few days, it is recommended that there be an opioid-free period of 5 or more days for heroin-dependent subjects and 10 or more days for those on medical maintenance. A naloxone challenge should be administered at a dosage of 0.8 mg. Use of naltrexone combined with psychotherapy appears to promote long periods of opioid abstinence but does not prevent relapse after treatment. Trained clinicians utilizing an appropriate induction protocol can effectively treat volunteer opioid addicts with naltrexone.
在一项针对160名患者（包括114名海洛因现用者和42名正在接受美沙酮、萘磺酸丙氧芬或长效美沙酮维持治疗的海洛因既往使用者）的研究中，受试者接受纳曲酮治疗的平均时长为50.7天（范围为1 - 635天）。在最后一剂阿片类药物使用后的10天内接受纳曲酮治疗的受试者，使用可乐定或胍那苄醋酸盐进行脱毒。由于有相当数量的受试者在治疗几天后就退出了，因此建议对于海洛因依赖者要有5天或更长时间的无阿片类药物期，对于接受医学维持治疗的患者要有10天或更长时间的无阿片类药物期。应给予0.8毫克剂量的纳洛酮激发试验。纳曲酮与心理治疗联合使用似乎能促进长时间的阿片类药物戒断，但不能防止治疗后复发。经过培训的临床医生采用适当的诱导方案，可以有效地用纳曲酮治疗自愿性阿片类药物成瘾者。
