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Nimodipine in opiate detoxification: a controlled trial
Juan Manuel Jiménez-Lerma1, Miguel Landabaso, Loseba Iraurgi
1Addiction Treatment Centre of Alava, Osakidetza, Basque Health Service, Araba, Spain.
Objective:
To evaluate the use of L-type calcium channel blockers (CaCB) in out-patient opiate detoxification.
Design:
Controlled trial with sequential allocation of patients to groups.
Methods:
Three groups of individuals subject to opiate detoxification were involved: (1) the experimental group (n=30) received a course of nimodipine and dextropropoxiphen; (2) one control group (n=20) was detoxified with a course of dextropropoxiphen and benzodiazepine; and (3) a second control group (n=30) was treated with a standard course of alpha-2-adrenergic agents and naltrexone. In all cases, the detoxification course was scheduled to last 7 days.
Results:
All the groups showed a significant opiate withdrawal syndrome (OWS) during detoxification (follow-up effect: Lambda=0.04; F6.52=201.89; P < 0.001), but from the first day the group treated with CaCB manifested fewer symptoms than the control groups (treatment effect: F2.57=97.99; P < 0.001). From the start, the intensity of the OWS was reduced by half in the CaCB group (M=6.67) compared with that manifested by the two other groups (M approximately 13). The clinical impression of the evolution of the detoxification was that it was comfortable and free of complications (significant side-effects were not observed).
Conclusions:
The results of the study suggest that the use of calcium channel blockers (CaCB) may be an effective method in opiate detoxification. Full randomized trials are warranted.