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Published on: April 23, 2019
Dextromethorphan and quinidine combination for heroin detoxification
Evaristo Akerele1, Adam Bisaga, Maria A Sullivan
1Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York, USA.
The American Journal on Addictions
|May 9, 2008
Summary
Dextromethorphan with quinidine (DM/Q) did not effectively reduce opioid withdrawal symptoms in a clinical trial. The combination was ineffective as a primary treatment, with high dropout rates observed.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Medicine
Background:
- Dextromethorphan (DM) shows preclinical promise for opioid withdrawal.
- Higher DM doses cause side effects due to its metabolite, dextrorphan.
- Quinidine inhibits DM metabolism, potentially reducing dextrorphan levels.
Purpose of the Study:
- To evaluate the efficacy of dextromethorphan with quinidine (DM/Q) in suppressing opioid withdrawal symptoms.
- To assess if quinidine co-administration mitigates DM-related side effects during opioid withdrawal treatment.
Main Methods:
- A randomized clinical trial involving opioid-dependent patients.
- Patients received morphine stabilization, followed by DM/Q or placebo before morphine discontinuation.
- Withdrawal symptoms were measured using the Modified Himmelsbach Opioid Withdrawal Scale (MHOWS).
Main Results:
- Withdrawal symptoms significantly increased post-morphine discontinuation in both groups.
- No significant difference in withdrawal symptom severity was observed between DM/Q and placebo groups.
- A high dropout rate (90%) occurred by study day 6, with no difference between groups.
Conclusions:
- Dextromethorphan with quinidine is ineffective as a standalone treatment for opioid withdrawal.
- Further research should explore DM as an adjunct therapy and investigate the dextrorphan-withdrawal relationship.
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