Buprenorphine-containing treatments :
place in the management of opioid addiction
by
Eder H, Fischer G, Gombas W,
Jagsch R, Stuhlinger G, Kasper S
Robinson SE.
Department of Pharmacology and Toxicology,
and Institute for Drug and Alcohol Studies,
Virginia Commonwealth University,
Richmond, Virginia, USA.t
CNS Drugs. 2006;20(9):697-712.
ABSTRACTAlthough the synthetic opioid buprenorphine has been available clinically for almost 30 years, its use has only recently become much more widespread for the treatment of opioid addiction.The pharmacodynamic and pharmacokinetic profiles of buprenorphine make it unique in the armamentarium of drugs for the treatment of opioid addiction. Buprenorphine has partial mu-opioid receptor agonist activity and is a kappa-opioid receptor antagonist; hence, it can substitute for other micro-opioid receptor agonists, yet is less apt to produce overdose reactions or dysphoria. On the other hand, buprenorphine can block the effects of opioids such as heroin (diamorphine) and morphine, and can even precipitate withdrawal in individuals physically dependent upon these drugs. Buprenorphine has significant sublingual bioavailability and a long half-life, making administration on a less than daily basis possible. Furthermore, its discontinuation is associated with only a mild withdrawal syndrome.Clinical trials have demonstrated that sublingual buprenorphine is effective in both maintenance therapy and detoxification of individuals addicted to opioids. The introduction of a sublingual formulation combining naloxone with buprenorphine further reduces the risk of diversion to illicit intravenous use. Because of its relative safety and lower risk of illegal diversion, buprenorphine has been made available in several countries for treating opioid addiction in the private office setting, greatly enhancing treatment options for this condition.Buprenorphine : structure
Buprenorphine and reward
Transdermal buprenorphine
Buprenorphine and naltrexone
Buprenorphine and the receptors
Buprenorphine for speedball users
Buprenorphine as an antidepressant
Buprenorphine: the standard wisdom
Buprenorphine : behavioral pharmacology
Buprenorphine versus buprenorphine/nalaxone
Buprenorphine (Buprenex, Temgesic) versus placebo or methadone
and further reading
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