Naldemedine-induced opioid withdrawal syndrome with severe psychiatric symptoms in an advanced cervical cancer patient without brain metastasis

2021 ◽  
pp. 1-3
Author(s):  
Mayumi Ishida ◽  
Mie Hiraoka ◽  
Ayako Yaguchi ◽  
Koji Sugano ◽  
Nasako Adachi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Brain Metastasis ◽  
Withdrawal Syndrome ◽  
Psychiatric Symptoms ◽  
Opioid Withdrawal ◽  
Cervical Cancer Patient ◽  
Opiate Withdrawal ◽  
Opioid Use ◽  
Behavioral Abnormalities ◽  
Opioid Withdrawal Syndrome

Abstract Objective Naldemedine, an oral peripheral μ-opioid receptor antagonist, was developed for the treatment of constipation, a side effect of opioid use. Naldemedine is not generally recognized as causing opioid withdrawal in which associated symptoms affecting the central nervous system. Method From the series of cancer patients undergoing symptom management, we report a case treated with naldemedine for constipation in relation to the use of opioids for cancer pain and who displayed severe psychological symptoms associated with withdrawal immediately after the use of naldemedine. Results The patient was a 36-year-old woman diagnosed with cervical cancer Stage IIB, PS3. When the patient, who was using oxycodone hydrochloride hydrate (80 mg/day) for ileal pain, was started on naldemedine for constipation, she complained of sweating after just 5 min and hallucinations after 1 h. The patient also displayed physical/behavioral abnormalities such as diarrhea and hyperactivity, and psychological abnormalities such as aggression toward staff. Despite the psychiatric symptoms worsening over time, there were no abnormalities in terms of blood biochemical data, and no brain metastasis was observed on MRI. Based on the Clinical Opiate Withdrawal Scale, these symptoms were judged to indicate opioid withdrawal. Naldemedine was discontinued due to naldemedine-related opioid withdrawal syndrome and, thereafter, the psychiatric symptoms diminished, with no recurrence of similar symptoms observed to date. Significance of results If mental and behavioral abnormalities occur in patients receiving naldemedine, it is necessary to consider the possibility of opioid withdrawal syndrome as a differential diagnosis.

Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome

Genomics ◽  
2021 ◽  
Author(s):  
Uppala Radhakrishna ◽  
Swapan K. Nath ◽  
Sangeetha Vishweswaraiah ◽  
Lavanya V. Uppala ◽  
Ariadna Forray ◽  
...  
Keyword(s):  
Transcriptome Analysis ◽  
Withdrawal Syndrome ◽  
Opioid Use Disorder ◽  
Opioid Withdrawal ◽  
Opioid Use ◽  
Opioid Withdrawal Syndrome

scholarly journals The Impact of Zinc Supplementation on Oxidative Stress and Inflammatory Biomarkers in Opioid Addicts-Withdrawal Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial

2021 ◽  
Author(s):  
Amir Keshavarzi ◽  
Ali Hassanalizade ◽  
Akram Ranjbar ◽  
Ali Ghaleiha ◽  
Seyed Yaser Vafaei ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Treatment Group ◽  
Withdrawal Syndrome ◽  
Zinc Supplementation ◽  
Opioid Withdrawal ◽  
Withdrawal Symptoms ◽  
Opiate Withdrawal ◽  
Control Group ◽  
Opioid Withdrawal Syndrome ◽  
The Impact

Abstract Background Opioid withdrawal can induce oxidative stress in opioid addicts. This interventional study aimed to investigate the effect of zinc supplementation on the oxidative profile of patients with an opioid withdrawal syndrome. Methods In the current study, 40 patients aged 18 to 65 years with opioid withdrawal syndrome were randomly assigned to intervention and control groups, each with 20 subjects. In addition to standard treatment, the intervention group received 30 mg of zinc daily, while the control group was given a placebo for one month. They were evaluated using Beck Depression Inventory (BDI), Clinical Opiate Withdrawal Scale (COWS), and Young Mania Rating Scale (YMRS) for withdrawal symptoms. Moreover, other parameters included catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) and levels of total antioxidant capacity (TAC), total thiol groups (TTG), tumor necrosis factor-α (TNF-α), and malondialdehyde (MDA). Results The rate of withdrawal symptoms (COWS) was statistically significantly lower in the treated group in comparison to the control group (P < 0.05). In the treatment group, the levels of TAC, CAT, SOD, and GPx increased significantly compared to the control group (P < 0.05). In the treatment group compared to the control group, there was a statistically significant decrease in hs-CRP, MDA, and TNFα (P < 0.05). Conclusions The results revealed that zinc supplementation could effectively reduce withdrawal symptoms by increasing antioxidant activity and reducing the lipid peroxidation index.

Cocaine use and Opioid Withdrawal Syndrome

1991 ◽  
Vol 6 (2) ◽  
pp. 89-92 ◽  
Author(s):  
JC Perez de los Cobos ◽  
JJ Lopez-Ibor ◽  
P Sopelana ◽  
M Castañeda
Keyword(s):  
Urine Sample ◽  
Withdrawal Syndrome ◽  
Opioid Dependence ◽  
Opioid Withdrawal ◽  
Therapeutic Failure ◽  
Opiate Withdrawal ◽  
Withdrawal Period ◽  
Cocaine Use ◽  
Opiate Withdrawal Syndrome ◽  
Opioid Withdrawal Syndrome

SummaryThe present study was carried out in 2 successive phases. In the first, 91 inpatients admitted for opioid dependence were evaluated. All were treated with α2-agonists during the withdrawal period. Shortly after admission, a urine sample was taken and analyzed (EMIT and GC/MS). The presence of the cocaine metabolite benzoilecgonine in urine was a predictor of dropout probability during hospitalization (P < 0.01). A second study on a sample of 612 inpatients later admitted for similar reasons was carried out according to a simpler protocol (using only EMIT) in order to replicate the previous results. Again, the presence of benzoilecgonine in urine indicated dropout probability (P = 0.00004). Thus, the use of cocaine prior to admission for a treatment of opiate withdrawal syndrome with α2-agonists seems to predict therapeutic failure.

Prenatal Use of Medication for Opioid Use Disorder and Other Prescription Opioids in Cases of Neonatal Opioid Withdrawal Syndrome: North Carolina Medicaid, 2016–2018

2021 ◽  
pp. e1-e4
Author(s):  
Anna E. Austin ◽  
Vito Di Bona ◽  
Mary E. Cox ◽  
Scott Proescholdbell ◽  
Michael Dolan Fliss ◽  
...  
Keyword(s):  
North Carolina ◽  
Withdrawal Syndrome ◽  
White Women ◽  
Opioid Use Disorder ◽  
Opioid Withdrawal ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
Opioid Withdrawal Syndrome ◽  
In Pregnancy

Objectives. To estimate use of medication for opioid use disorder (MOUD) and prescription opioids in pregnancy among mothers of infants with neonatal opioid withdrawal syndrome (NOWS). Methods. We used linked 2016–2018 North Carolina birth certificate and newborn and maternal Medicaid claims data to identify infants with an NOWS diagnosis and maternal claims for MOUD and prescription opioids in pregnancy (n = 3395). Results. Among mothers of infants with NOWS, 38.6% had a claim for MOUD only, 14.3% had a claim for prescription opioids only, 8.1% had a claim for both MOUD and prescription opioids, and 39.1% did not have a claim for MOUD or prescription opioids in pregnancy. Non-Hispanic Black women were less likely to have a claim for MOUD than non-Hispanic White women. The percentage of infants born full term and normal birth weight was highest among women with MOUD or both MOUD and prescription opioid claims. Conclusions. In the 2016–2018 NC Medicaid population, 60% of mothers of infants with NOWS had MOUD or prescription opioid claims in pregnancy, underscoring the extent to which cases of NOWS may be a result of medically appropriate opioid use in pregnancy. (Am J Public Health. Published online ahead of print August 12, 2021: e1–e4. https://doi.org/10.2105/AJPH.2021.306374 )

scholarly journals Naldemedine-induced Opioid Withdrawal Syndrome in a Patient with Breast Cancer without Brain Metastasis

2020 ◽  
Vol 59 (2) ◽  
pp. 293-296 ◽  
Author(s):  
Koji Ishii ◽  
Haruna Yamashita ◽  
Midori Yamaguchi ◽  
Yuya Komatsu ◽  
Emi Ryu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Withdrawal Syndrome ◽  
Opioid Withdrawal ◽  
Opioid Withdrawal Syndrome

scholarly journals Buprenorphine for Medication-Assisted Treatment of Opioid Use Disorder in Pregnancy: Relationship to Neonatal Opioid Withdrawal Syndrome

2017 ◽  
Vol 07 (04) ◽  
pp. e215-e222 ◽  
Author(s):  
Niraj Chavan ◽  
Kristin Ashford ◽  
Amanda Wiggins ◽  
Michelle Lofwall ◽  
Agatha Critchfield
Keyword(s):  
Withdrawal Syndrome ◽  
Opioid Use Disorder ◽  
Opioid Withdrawal ◽  
Study Cohort ◽  
Urine Drug Screen ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
Positive Urine ◽  
Opioid Withdrawal Syndrome ◽  
In Pregnancy

Objective To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups—pregnancies with versus without NOWS. Substance abuse patterns in pregnancy, maternal, and neonatal clinical outcomes were compared. Results The incidence of NOWS was 31.11% (n = 28/90) in our study cohort. Pregnancies with NOWS had a significantly higher rate of benzodiazepine positive urine tests and number of positive urine drug screen (UDS) results for illicit opioids. The group without NOWS had significantly higher number of patients with an appropriate UDS result at delivery through postpartum. Rates of neonatal intensive care unit (NICU) admission, length of NICU stay, and maximum Finnegan score were significantly higher in the group with NOWS. Neither the initial (10.6 ± 5.2 versus 10.3 ± 4.8 mg, p = 0.80) nor the final buprenorphine doses (13.3 ± 5.1 versus 13.0 ± 4.6 mg, p = 0.81) were significantly different between study groups. Conclusion The occurrence of NOWS was not related to buprenorphine dose used for MAT.

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