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Vivitrol Treatment for Alcoholism and Addiction

Blocks Effects of Drugs, Reduces Cravings

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Updated June 23, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Vivitrol

Vivitrol

© Alkermes, Inc.
Vivitrol is an extended-release formulation of naltrexone, an opioid receptor antagonist used in the treatment of alcoholism and opioid addiction. Naltrexone hydrochloride is marketed for both daily and once-a-month dosages.

Vivitrol is the once-a-month form of the medication. The U.S. Food and Drug Administration approved Vivitrol for the treatment of alcohol abuse in 2006, and in 2010 they approved it for the treatment of opioid addiction as well.

How Does Vivitrol Work?

Vivitrol is prescribed for people who have already stopped drinking and using opioid drugs (such as morphine, heroin and prescription pain medications) and who have gone through a detoxification process. Vivitrol works by blocking the effect that alcohol or opioids have on the brain, and reduces the cravings that many people experience after they quit.

As an opioid receptor antagonist, Vivitrol blocks the usual brain reaction that produces a feeling of pleasure with opioids are consumed. With alcohol, it is not certain how Vivitrol actually works, but it seems to affect the endogenous opioid reinforcement system. In other words, it changes how the brain responds to alcohol and drug consumption.

How Is Vivitrol Taken?

Unlike the daily dosage form of the drug, Vivitrol is administered by intramuscular injection once a month. One of the main problems with the daily dosages of naltrexone was medication compliance; patients had to remember and be willing to take the pills each day. With the once-a-month shot, medication compliance is less of a factor in the treatment plan.

What Are the Side Effects?

According to the FDA, side effects experienced by those using Vivitrol during trial studies included nausea, tiredness, headache, dizziness, vomiting, decreased appetite, painful joints, and muscle cramps. Other potential serious side effects included reactions at the site of the injection, which can be severe and may require surgical intervention, liver damage, allergic reactions such as hives, rashes, swelling of the face, pneumonia, depressed mood, suicide, suicidal thoughts, and suicidal behavior.

According to Alkermes, the manufacturer of the drug, the main side effects experienced by patients who took the drug were inflammation of nasal passages, increased liver enzymes, and insomnia.

Who Can Take Vivitrol?

Vivitrol should be used only for patients who have completely detoxed from alcohol and opioids. It is not intended to help someone stop drinking or doing drugs. According to the FDA, patients "must not have any opioids in their system when they start taking Vivitrol; otherwise, they may experience withdrawal symptoms from the opioids. Also, patients may be more sensitive to opioids while taking Vivitrol at the time their next scheduled dose is due. If they miss a dose or after treatment with Vivitrol has ended, patients can accidentally overdose if they restart opioid use."

The safety information that is provided with the medication also warns that Vivitrol should not be taken by patients with acute hepatitis or liver failure.

How Is Vivitrol Different From Other Medications?

Vivitrol is the first non-narcotic, non-addictive, extended release medication approved for the treatment of opioid dependence. Other medications approved for the treatment of opioid addiction are methadone and bepenorphrine, both of which can be addictive. Methadone is available only through specialized clinics. Buprenorphine is available through doctors' offices, but it and methadone require daily doses.

How Effective Is Vivitrol?

Naltrexone has been used for years in the treatment of alcohol abuse with varying success. When the once-a-month version of the medication was developed, research showed that it was more effective than daily medications that required the patient to stick to a daily treatment regimen.

Double-blind, placebo-controlled clinical trials have shown Vivitrol to be effective in preventing relapse as well as reducing cravings. In the FDA trials, patients treated with Vivitrol were more likely to stay in treatment and to refrain from using illicit drugs. Of those taking Vivitrol, 36% were able to stay in treatment for the full six months without using drugs, compared with 23% in the placebo group.

Like most pharmaceutical treatments for alcohol and drug abuse, Vivitrol works best if it is used in connection with an overall treatment program, such as psychosocial therapy, counseling or support group participation.

Sources:

Alkermes, Inc. Vivitrol.com Manufacturer's website. October 2010.

U.S. Food and Drug Administration. "FDA approves injectable drug to treat opioid-dependent patients," October 2010.

National Institute on Drug Abuse. "Important Treatment Advances for Addiction to Heroin and other Opiates," October 2010.

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