Florid opioid withdrawal-like reaction precipitated by naltrexone in a patient with chronic cholestasis

E.A. Jones, L.R.C. Dekker

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

55 Citaten (Scopus)
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Samenvatting

Findings consistent with the hypothesis that increased central opioidergic tone contributes to the pruritus of cholestasis provide a rationale for treating this form of pruritus with opiate antagonists. However, initiation of therapy with an opiate antagonist in a cholestatic patient may precipitate a transient opioid withdrawal-like reaction. A woman with chronic cholestasis and disabling pruritus experienced severe transient opioid withdrawal-like reactions after oral administration of 12.5 and 2 mg naltrexone. Subsequently, naloxone was administered by intravenous infusion. Initially, the infusion rate was low and subtherapeutic. It was gradually increased to a rate known to be effective in inducing opioid antagonism. Oral naltrexone was then reintroduced without any reaction occurring. During the ensuing 12 months, while taking naltrexone, 25 mg daily, the patient has been completely free from pruritus. These observations strongly support the hypothesis that increased central opioidergic tone is a component of the pathophysiology of cholestasis.

Originele taal-2Engels
Pagina's (van-tot)431-432
Aantal pagina's2
TijdschriftGastroenterology
Volume118
Nummer van het tijdschrift2
DOI's
StatusGepubliceerd - feb 2000
Extern gepubliceerdJa

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