2011
The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Substance Use and Related Disorders. Part 2: Opioid dependence
Soyka M, Kranzler HR, van den Brink W, Krystal J, Möller HJ, Kasper S, Treatment G. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Substance Use and Related Disorders. Part 2: Opioid dependence. The World Journal Of Biological Psychiatry 2011, 12: 160-187. PMID: 21486104, DOI: 10.3109/15622975.2011.561872.Peer-Reviewed Original ResearchMeSH KeywordsAdultAryl Hydrocarbon HydroxylasesBuprenorphineCytochrome P-450 CYP2B6Cytochrome P-450 CYP2D6Drug Therapy, CombinationEvidence-Based MedicineGenetic VariationHumansMethadoneNarcotic AntagonistsNarcoticsOpiate Substitution TreatmentOpioid-Related DisordersOxidoreductases, N-DemethylatingPsychotherapyReceptors, OpioidSocial SupportStandard of CareSubstance Withdrawal SyndromeConceptsOpioid dependenceOpioid abusePractice guidelinesEvidence-based practice guidelinesBiological Psychiatry (WFSBP) GuidelinesOpioid agonist methadoneSecond-line medicationsNational treatment guidelinesNumber of medicationsEfficacy of methadoneOpioid use disorderEvidence-based guidelinesRandomized clinical trialsCombination of buprenorphineWorld FederationInternational task forceStrength of evidenceOpioid withdrawalAdjunctive medicationsOpioid maintenanceTreatment guidelinesTask ForceCochrane LibraryPharmacological treatmentClinical trials
2002
Yohimbine-induced withdrawal and anxiety symptoms in opioid-dependent patients
Stine SM, Southwick SM, Petrakis IL, Kosten TR, Charney DS, Krystal JH. Yohimbine-induced withdrawal and anxiety symptoms in opioid-dependent patients. Biological Psychiatry 2002, 51: 642-651. PMID: 11955464, DOI: 10.1016/s0006-3223(01)01292-6.Peer-Reviewed Original ResearchConceptsOpioid-dependent patientsBlood pressureMethadone patientsOpioid dependenceHPA axis perturbationsPlacebo-controlled studyDiastolic blood pressureSystolic blood pressureMethadone-maintained patientsSymptom scale scoresSynaptic noradrenalineOpioid withdrawalPostsynaptic effectsMHPG levelsAbstinence symptomsAdrenal axisOpioid drugsYohimbine effectNoradrenergic regulationHealthy volunteersHeart ratePhysiologic measuresPatientsCortisol levelsScale score
2001
Methadone patients exhibit increased startle and cortisol response after intravenous yohimbine
Stine S, Grillon C, Morgan III C, Kosten T, Charney D, Krystal J. Methadone patients exhibit increased startle and cortisol response after intravenous yohimbine. Psychopharmacology 2001, 154: 274-281. PMID: 11351934, DOI: 10.1007/s002130000644.Peer-Reviewed Original ResearchConceptsMethadone-maintained patientsAcoustic startle responseCortisol levelsMethadone patientsMHPG levelsAnalysis of covarianceLower baseline plasma levelsStartle responseBaseline plasma cortisol levelsOpioid agonist maintenanceBrain noradrenergic systemCortisol serum levelsDouble-blind fashionBaseline plasma levelsMethadone-maintained subjectsWithdrawal-like symptomsPlasma cortisol levelsPrevious reportsIntravenous yohimbineMethadone effectsOpioid withdrawalSerum levelsNoradrenergic mechanismsOpioid dependenceYohimbine effect
1995
Opiate Dependence and Withdrawal: Preliminary Assessment Using Single Photon Emission Computerized Tomography (SPECT)
Krystal J, Woods S, Kosten T, Rosen M, Seibyl J, Van Dyck C, Price L, Zubal I, Hoffer P, Charney D. Opiate Dependence and Withdrawal: Preliminary Assessment Using Single Photon Emission Computerized Tomography (SPECT). The American Journal Of Drug And Alcohol Abuse 1995, 21: 47-63. PMID: 7762544, DOI: 10.3109/00952999509095229.Peer-Reviewed Original ResearchConceptsRegional brain functionOpiate withdrawal signsSingle Photon Emission Computerized TomographyHealthy subjectsNaloxone administrationOpiate withdrawalOpiate dependenceBrain functionParietal cortexHexamethylpropyleneamine oximeWithdrawal signsNaloxone effectChronic opiate dependencePlacebo-controlled studyRegional alterationsComparison of patientsMethadone-maintained patientsRegional cerebral perfusionPhoton Emission Computerized TomographyOpiate-dependent patientsRight temporal cortexRight parietal cortexFunctional brain imaging technologiesSingle photon emissionEmission computerized tomography
1992
Baclofen-assisted detoxification from opiates A pilot study
Krystal J, McDougle C, Kosten T, Price L, Aghajanian G, Charney D. Baclofen-assisted detoxification from opiates A pilot study. Journal Of Substance Use And Addiction Treatment 1992, 9: 139-142. PMID: 1324986, DOI: 10.1016/0740-5472(92)90081-x.Peer-Reviewed Original ResearchConceptsOpen-label pilot studyPilot studyLabel pilot studyOpiate-dependent patientsAbrupt discontinuationOral dosesOpiate detoxificationAdjunctive rolePrimary treatmentOpiate dependencePatientsBaclofenInsufficient suppressionDose rangeMyalgiaVomitingClonidineDiscontinuationMedicationsHeadacheMethadoneDetoxificationDoses
1990
Opioid antagonist challenges in buprenorphine maintained patients
Kosten T, Krystal J, Charney D, Price L, Morgan C, Kleber H. Opioid antagonist challenges in buprenorphine maintained patients. Drug And Alcohol Dependence 1990, 25: 73-78. PMID: 2323312, DOI: 10.1016/0376-8716(90)90144-4.Peer-Reviewed Original ResearchConceptsSublingual buprenorphine treatmentBlood pressure increaseDouble-blind placeboOpioid withdrawal symptomsBlind placeboIntravenous naloxoneNaltrexone challengeOral naltrexoneLast doseBlood pressureBuprenorphine treatmentPlacebo substitutionMHPG levelsWithdrawal symptomsPlacebo challengeSignificant symptomsAntagonist challengeBuprenorphinePatientsPlaceboNaloxoneSymptomsNaltrexoneDoseMonths
1989
Intermittent naloxone attenuates the development of physical dependence on methadone in rhesus monkeys
Krystal J, Walker M, Heninger G. Intermittent naloxone attenuates the development of physical dependence on methadone in rhesus monkeys. European Journal Of Pharmacology 1989, 160: 331-338. PMID: 2540995, DOI: 10.1016/0014-2999(89)90088-5.Peer-Reviewed Original ResearchConceptsOpiate withdrawal syndromeInjection of naloxoneWithdrawal syndromeTreatment periodNaloxone injectionNaloxone administrationWithdrawal responsePhysical dependenceDays of methadoneAntagonist exposureMethadone treatmentDaily injectionsLack of incrementReceptor mechanismsDrug combinationsNaloxoneRhesus monkeysSyndromeDay 16MethadoneSame monkeysManagement of situationsInjectionAdministrationDays
1984
Multiple Mechanisms of withdrawal from Opioid Drugs
Redmond DE, Krystal JH. Multiple Mechanisms of withdrawal from Opioid Drugs. Annual Review Of Neuroscience 1984, 7: 443-478. PMID: 6324646, DOI: 10.1146/annurev.ne.07.030184.002303.Peer-Reviewed Original ResearchAcetylcholineAdenine NucleotidesAnimalsBenzodiazepinesCalciumCalmodulinClonidineConditioning, PsychologicalCyclic GMPDopamineDrug ToleranceEnkephalinsFearGamma-Aminobutyric AcidHumansMethadoneNaloxoneNarcotic AntagonistsNarcoticsNeuronsNorepinephrineProtein ConformationReceptors, OpioidSerotoninSubstance Withdrawal Syndrome