The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data

Most women using heroin are of reproductive age with major risks for their infants. We review clinical and experimental data on fetal, neonatal and postnatal complications associated with methadone, the current "gold standard", and compare these with more recent, but limited, data on devel...

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Main Authors: Farid, W., Dunlop, S., Tait, Robert, Hulse, G.
Format: Journal Article
Published: 2008
Online Access:http://hdl.handle.net/20.500.11937/6289
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author Farid, W.
Dunlop, S.
Tait, Robert
Hulse, G.
author_facet Farid, W.
Dunlop, S.
Tait, Robert
Hulse, G.
author_sort Farid, W.
building Curtin Institutional Repository
collection Online Access
description Most women using heroin are of reproductive age with major risks for their infants. We review clinical and experimental data on fetal, neonatal and postnatal complications associated with methadone, the current "gold standard", and compare these with more recent, but limited, data on developmental effects of buprenorphine, and naltrexone. Methadone is a µ-opioid receptor agonist and is commonly recommended for treatment of opioid dependence during pregnancy. However, it has undesired outcomes including neonatal abstinence syndrome (NAS). Animal studies also indicate detrimental effects on growth, behaviour, neuroanatomy and biochemistry, and increased perinatal mortality. Buprenorphine is a partial µ-opioid receptor agonist and a ?-opioid receptor antagonist. Clinical observations suggest that buprenorphine during pregnancy is similar to methadone on developmental measures but is potentially superior in reducing the incidence and prognosis of NAS. However, small animal studies demonstrate that low doses of buprenorphine during pregnancy and lactation lead to changes in offspring behaviour, neuroanatomy and biochemistry. Naltrexone is a non-selective opioid receptor antagonist. Although data are limited, humans treated with oral or sustained-release implantable naltrexone suggest outcomes potentially superior to those with methadone or buprenorphine. However, animal studies using oral or injectable naltrexone have shown developmental changes following exposure during pregnancy and lactation, raising concerns about its use in humans. Animal studies using chronic exposure, equivalent to clinical depot formulations, are required to evaluate safety. While each treatment is likely to have maternal advantages and disadvantages, studies are urgently required to determine which is optimal for offspring in the short and long term. © 2008 Bentham Science Publishers Ltd.
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spelling curtin-20.500.11937-62892018-03-29T09:05:43Z The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data Farid, W. Dunlop, S. Tait, Robert Hulse, G. Most women using heroin are of reproductive age with major risks for their infants. We review clinical and experimental data on fetal, neonatal and postnatal complications associated with methadone, the current "gold standard", and compare these with more recent, but limited, data on developmental effects of buprenorphine, and naltrexone. Methadone is a µ-opioid receptor agonist and is commonly recommended for treatment of opioid dependence during pregnancy. However, it has undesired outcomes including neonatal abstinence syndrome (NAS). Animal studies also indicate detrimental effects on growth, behaviour, neuroanatomy and biochemistry, and increased perinatal mortality. Buprenorphine is a partial µ-opioid receptor agonist and a ?-opioid receptor antagonist. Clinical observations suggest that buprenorphine during pregnancy is similar to methadone on developmental measures but is potentially superior in reducing the incidence and prognosis of NAS. However, small animal studies demonstrate that low doses of buprenorphine during pregnancy and lactation lead to changes in offspring behaviour, neuroanatomy and biochemistry. Naltrexone is a non-selective opioid receptor antagonist. Although data are limited, humans treated with oral or sustained-release implantable naltrexone suggest outcomes potentially superior to those with methadone or buprenorphine. However, animal studies using oral or injectable naltrexone have shown developmental changes following exposure during pregnancy and lactation, raising concerns about its use in humans. Animal studies using chronic exposure, equivalent to clinical depot formulations, are required to evaluate safety. While each treatment is likely to have maternal advantages and disadvantages, studies are urgently required to determine which is optimal for offspring in the short and long term. © 2008 Bentham Science Publishers Ltd. 2008 Journal Article http://hdl.handle.net/20.500.11937/6289 10.2174/157015908784533842 restricted
spellingShingle Farid, W.
Dunlop, S.
Tait, Robert
Hulse, G.
The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data
title The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data
title_full The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data
title_fullStr The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data
title_full_unstemmed The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data
title_short The effects of maternally administered methadone, buprenorphine and naltrexone on offspring: Review of human and animal data
title_sort effects of maternally administered methadone, buprenorphine and naltrexone on offspring: review of human and animal data
url http://hdl.handle.net/20.500.11937/6289