[Naltrexone implant treatment of polydrug dependence]. / Primenenie implanta naltreksona dlia terapii polinarkomanii.

Objective. Recent studies indicate that naltrexone implant may be one of the effective pharmacological treatments for opiate dependence. However, nowadays many of addicts are polydrug dependent. The aim of the study was to evaluate the effectiveness of naltrexone implant in the treatment of opiate and amphetamine polydrug dependence. Material and methods. A 10-week randomized, double-blind, placebo-controlled trial with 100 patients dependent on opiates and amphetamines has been conducted. Subjects were randomized in 1:1 ratio to either naltrexone implant or identically looking placebo formulation group. Primary outcome measures were retention in the study, proportion of drug-free urine samples and improvement in the Clinical Global Impression (CGI) scale. Results. At week 10, the retention was 52% among patients with naltrexone vs. 28% among patients with placebo implant (p=0.01), and the proportion of drug-free urine samples was 38% vs. 16% (p=0.01), respectively. Fifty-six per cent of patients treated with naltrexone implant showed marked improvement on CGI compared with 14% of patients treated with placebo (p<0.001, NNT=3.95%, CI 2-4). Conclusion. Naltrexone implant administration resulted in higher retention in the treatment, decreased heroin and amphetamine use, and improved clinical condition of patients, providing the first evidence on effective pharmacological treatment of this kind of polydrug dependence.

[Clinical and laboratory evaluation of the efficiency of chronic hemodialysis treatment using acidosuccinate in patients with terminal renal failure].

AIM: To evaluate the efficiency of using a succinate-containing dialysis solution (SCDS) in terminal renal failure patients treated with chronic hemodialysis (CHD). SUBJECTS AND METHODS: Ninety patients from two hemodialysis units took part in the crossover study and were allocated to 2 groups. For 6 months, study group patients received CHD using SCDS and control group patients had CHD with a standard bicarbonate dialysis solution after 3-month washout period followed by decussation. The time course of changes in blood biochemical parameters, 24-hour ECG monitoring data, and quality of life indicators were estimated in the patients. RESULTS: After using acidosuccinate during hemodialysis, there was a significant reduction in the predialysis serum level of inorganic phosphate, a calcium phosphate product, gamma-glutamyl transpeptidase, urea, and aldosterone as compared to the control group. The blood concentration of total protein was also increased. After 6-month administration of acidosuccinate, the patients showed reductions in systolic blood pressure, heart rate, and the frequency and duration of ST-segment depression episodes. There were positive changes in the quality of life of patients according to the KDQOL-SF questionnaire. CONCLUSION: The use of SCDS in patients with CHD causes positive changes in a number of laboratory parameters and improves the physical and general status, and quality of life of patients.

[Naltrexone and fluoxetine for maintenance of remission in patients with heroin addiction: a double-blind randomized placebo-controlled trial].

Two hundreds and eighty patients with heroin addiction were randomized into 4 equal groups. Patients of the group 1 received naltrexone (N) in dosage 50 mg/day and fluoxetine (F) in dosage 20 mg/day during 6 months. Group 2 received N/F-placebo (FN), group 3--N-placebo (NP)/F and group 4--NP/FP. All patients underwent a session of individual psychotherapy for the maintenance of remission. Express urine drugs tests were used for remission control. Compliance was controlled by a riboflavin marker. Clinical state, psychiatric status and social functioning were assessed using quantified international scales and tests. To the end of the 6 month course, 43% of patients of group 1, 36% of group 2, 21% of group 3 and 10% of group 4 were in remission. Therefore, N/F was more effective than F/NP (p < 0.01) and FP/NP (p < 0.001); N/FP was more effective than F/NP (p < 0.05) and NP/FP (p < 0.001); F/NP did not differ significantly from NP/FP (p = 0.1); N/F did not differ from N/FP (p = 0.2). However N/F was more effective compared to N/FP only in women, probably, due to the higher baseline levels of depression, anxiety and anhedonia. Naltrexone was superior to placebo and fluoxetine in the efficacy of maintenance of remission and preventing relapse in patients with heroin addiction. The combination of naltrexone and fluoxetine was more effective compared to the monotherapy with naltrexone in women only.

[Ritanserin prolongs the analgesic effect of morphine and slows the development of tolerance]. / Ritanserin prolongiruet anal'geticheskii éffekt morfina i zamedliaet razvitie tolerantnosti.

The effect of 5-HT2 receptor blocker ritanserine on the analgesic effect of morphine was studied in experiments on mice. A single simultaneous injection of ritanserine (10 mg/kg) and morphine (1, 10, and 20 mg/kg) prolonged the duration of analgesia in the tail clip test. Combined subchronic (6 days) injection of morphine and ritanserine (1, 5, and 10 mg/kg) twice a day delayed the development of tolerance to the opiate analgesic effect in the hot plate and tail clip tests.

[The effect of ritanserin on the formation and expression of an opiate abstinence syndrome]. / Vliianie ritanserina na formirovanie i ékspressiiu opiatnogo abstinentnogo sindroma.

The described dependence was formed in mice [correction of rats] by subcutaneous injections of morphine in doses growing from 10 to 100 mg/kg (8 days, twice a day). The effect of 5-HT2 receptor blocker ritanserine (1, 5, and 10 mg/kg) on expression of the abstinence syndrome (according to the behavioral and somato-autonomic parameters) 24 h after morphine discontinuation was studied. Ritanserine attenuated the manifestation of some abstinence parameters associated with activation of the serotonin system in formation of the dependence. The effect was less in expression of abstinence.

[A computer ethological-pharmacological analysis of the intraspecific behavior of primates]. / Komp'iuternyi étologo-farmakologicheskii analiz vnutrividnogo povedeniia primatov.

Experiments were performed on primates (Cercopithecus sabeus, Macaca maurus, Cebus apella). Possibility to formalize the structure of normal and pathological monkey behaviour was shown by computerized technique. Rigid dominant-subordinate structures (linear type) were demonstrated on Macaca maurus, Cercopithecus sabeus, Cebus apella. These structures display some variants of normal relationship between monkeys. Raising in isolation from conspecifics determines behavioural disadaptation and pathological behaviour, e.g. "timid-defensive" syndrome. Model of "timid-defensive" syndrome in isolated primates seems to be useful for psycho-pharmacological research, for assessment of anxiolytic and antidepressive properties of drugs.