Memantine as a Supplement to Naltrexone in Treating Heroin Dependence (US, NYC)

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nuke

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Summary:
Free treatment for heroin or opiate abuse. Research study involves inpatient detox and outpatient care.

The number of new heroin users and problems associated with heroin use has increased steadily over the past several years. While methadone maintenance remains the most effective treatment for opioid dependence, it has several limitations and is controversial.

Naltrexone maintenance is an alternate treatment for opiate dependence that is promising, but currently has limited usefulness due to poor patient compliance and low patient acceptability. There is strong support from animal research that another class of drugs, NMDA-R antagonists, may also be an effective treatment for opiate dependence. In laboratory animals, NMDA-R antagonists have inhibited behaviors associated with relapse, reduced opiate self-administration, and helped with withdrawal symptoms. In humans, NMDA-R antagonists have reduced signs and symptoms associated with opiate withdrawal and reduced heroin craving. The primary aim of this study is to determine the efficacy of memantine as an adjunct to naltrexone maintenance in detoxified heroin-dependent individuals.

Prospective participants will undergo a screening process at the clinic to determine eligibility. After screening, eligible patients will complete an 8-day inpatient detoxification, followed by a 12-week outpatient phase. During the outpatient phase, patients will be assigned to one of three medication groups: 1) Naltrexone + Placebo; 2) Naltrexone + Memantine 30 mg twice daily; 3) Naltrexone + Memantine 60 mg twice daily. The outpatient treatment will also consist of 3 weekly visits to the clinic in which patients will receive counseling to help maintain abstinence and improve compliance with study medication. In addition to providing treatment referrals, follow up assessments will be completed one, two, and three months after the completion of treatment.
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http://www.clinicaltrials.gov/ct/show/NCT00476242

Inclusion Criteria:
Adult, aged 18-60.
Meets DSM-IV criteria for current opiate dependence disorder of at least six months duration, supported by a positive urine for opiates and a positive naloxone challenge test if the diagnosis is unclear.
Able to give informed consent.

Exclusion Criteria:
Pregnancy, lactation, or failure in a sexually active woman to use adequate contraceptive methods.
Active medical illness which might make participation hazardous, such as untreated hypertension, acute hepatitis with SGOT or SGPT levels >2 times normal, unstable diabetes, chronic organic mental disorder (e.g., AIDS dementia).
Active psychiatric disorder which might interfere with participation or make participation hazardous, including DSM-IV schizophrenia, bipolar disorder with mania or psychosis, and depressive disorder with suicide risk or 1 or more suicide attempts within the past year.
History of allergic reaction to buprenorphine, naloxone, memantine, naltrexone, clonidine, or clonazepam.
Currently prescribed or regularly taking opiates for chronic pain or medical illness.
Current participation in another intensive psychotherapy or substance abuse treatment program or currently prescribed psychotropic medications.
Current participation in a methadone maintenance treatment program and/or regular use of illicit methadone (>30 mg per week).
History of accidental drug overdose in the last three years or any other significant history of overdose following detoxification defined as an episode of opioid-induced unconsciousness or incapacitation, whether or not medical treatment was sought or received.

Started June 2005; currently in progress and accepting new participants.

Contact
Please refer to this study by ClinicalTrials.gov identifier NCT00476242

Kovi Yaacov, BA 212- 923-3031

United States, New York
STARS, New York, New York, 10032, United States; Recruiting
Kovi Elkus, BA 212-923-3031
Adam Bisaga, MD, Principal Investigator

(Please do not PM me in regards to this, I am not affiliated with this research)
 
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Awesome, I'm always loking for more info on memantine. Thanks Nuke:)
 
mementine

mementine/ naltrexone both supposed NMDA-r antagonists

I believe these trials are using mementine as a supplement to naltrexone in treating heroin/opiate dependence.
also mentioned was the supposed reduced cravings for opiates/heroin
there are numerous trial studies going on with mementine.
treatment of the early stages of alzheimers. bi-polar disorders.
#17 for the heroin trials there are numerous trial going on .

anything to add about mementine?
 
I found out that NMDA antagonists can completely remove heroin cravings by pure luck, and it saved my life. Me and my brother were both quitting heroin, and on the third or fourth day we decided to buy some ketamine (which has NMDA antagonist effects, as DXM and ibogain have too) to numb the body so it didn't hurt so bad and just get the time to pass.

Anyways, after our trip, I noticed I suddenly didn't think about heroin anymore, which was strange, because every other time I've tried to quit I think about it 24/7 and just wait till I can try it again. Now all the cravings were gone, the withdrawal depression from hell was gone and for the first time I felt like this time I could actually quit. Now it's been 3 weeks and 2 days (my previous record was 12 days), and I don't even think about heroin at all. And almost every day I'm with people who shoot or smoke dope in front of me, but I don't care since I don't want to do heroin anyways.

My brother experienced exactly the same thing, so we gave some ketamine to a friend who was trying to quit and was super depressed, but now it's gone with the cravings.

So I searched the web for ketamine and heroin addiction and found this study: http://www.heffter.org/review/Review2/chap7.pdf
They have also used ketamine to treat alchoholics. And I just noticed MAPS has been updated (or I've never seen it there before) with a ketamine section for quitting heroin: http://www.maps.org/research/ketamine/04Kheroin.html I don't know why NMDA antagonists seems to remove cravings, but the NMDA receptor complex is associated with learning and memory, and it almost feel as if my brain has been reset so it has forgotten about heroin, or the reward circuitry has been reset. I thought about heroin under the trip and that I needed to stop, but it wasn't any enlightning experience or anything, so it has to some magic the NMDA antagonists does. Plus the depression part is maybe because of the recent study where ketamine was found to relieve depression immidiately, and I think that is a big help too when you don't want to kill yourself every day but feel fine and know that this time it's different.

Anyways, I can't believe how lucky I was I just decided to buy some ketamine in the middle of withdrawal, I've only used ketamine maybe 2 times before that or something. So try it out, recommend it to all your friends who's life is being ruined by opiates. It's the best thing that ever happened to me.
 
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Thats a really interesting study / post.

I am quite a heavy drinker and I have found that ketamine helps with not giving a shit about drinking. I bought a gram of K the other day and spaced it out with a few mild doses over 3 days and I didnt once think about drink for any of those days (even though I only took K within 3 - 5 hours of going to sleep.

Has anyone noticed that after a night full of mild ketamine use you wake up feeling refreshed?
 
This study has now been published, their hypothesis that memantine would help in opiate treatment wasn't supported. You can find a summary of the results here
http://www.ncbi.nlm.nih.gov/pubmed/21715107?dopt=Abstract

Nodnormal - it's a shame that your experiences weren't supported by the research, looks like it really worked for you! Maybe the experience on ketamine was more complex than the memantine study could capture?
 
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