fluvoxamine and Opioid-Related-Disorders

Drug dependence is a social problem of over the world and resistant to medical intervention by psychiatrist as well as general clinicians. In Japan, methamphetamine dependence is one of the most critical social problems, but opioid dependence is relatively rare. Pentazocine was called the non-addictive opioid at the time of development and release and there are few reports of its dependence. We experienced a medical worker with pentazocine dependence. He started to use pentazocine to reduce serious migraine and felled into dependence by changing the purpose to relaxation of stammering fear and strain towards other people. He was successfully treated by cognitive therapy.

Topics: Adult; Analgesics, Opioid; Anti-Anxiety Agents; Cognitive Behavioral Therapy; Diazepam; Fluvoxamine; Humans; Male; Opioid-Related Disorders; Pentazocine; Substance Withdrawal Syndrome; Tranquilizing Agents; Treatment Outcome

Methadone has been effectively used in the treatment of opiate dependence. Adequate dose and blood level have correlated with success in treatment. A number of factors including the regular use of alcohol, medications, and urinary pH can influence blood level and thereby effectiveness. Fluvoxamine has been shown to increase methadone blood levels.. Single case report.. A patient unable to maintain an effective methadone blood level despite a dose of 200 mg per day was administered fluvoxamine with subsequent increase in her methadone blood level and reduction of opiate withdrawal symptoms.. In patients unable to maintain an effective methadone blood level throughout the dosing interval, fluvoxamine can help increase the methadone blood level and alleviate opiate withdrawal symptoms.

Topics: Adult; Drug Interactions; Female; Fluvoxamine; Humans; Methadone; Narcotics; Opioid-Related Disorders; Selective Serotonin Reuptake Inhibitors; Substance Withdrawal Syndrome

We report five cases where fluvoxamine (FLVX) was added to maintenance treatment with methadone (MTD) in addict patients with affective disorders. In view of the implication of FLVX in several metabolic drug interactions, MTD plasma levels were measured before and after treatment with FLVX. A slight increase (approximately 20% of the MTD plasma level/dose ratio) occurred in two cases. In the remaining three patients, the interaction was more pronounced (40-100% increase of the MTD plasma level/dose ratio), with clinical manifestations of opiate withdrawal after stopping FLVX therapy in one case. Caution is needed when starting or stopping treatment with FLVX in patients receiving maintenance treatment with methadone.

Topics: Adult; Depressive Disorder; Drug Interactions; Female; Fluvoxamine; Humans; Male; Methadone; Opioid-Related Disorders