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Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl.
JAMA Netw Open
January 2025
San Francisco Department of Public Health, San Francisco, California.
Importance: The rise of high-potency opioids such as fentanyl makes buprenorphine initiation challenging due to the risks of precipitated withdrawal, prompting the exploration of strategies, such as low-dose initiation (LDI) of buprenorphine. However, no comparative studies on LDI outcomes exist.
Objective: To evaluate outpatient outcomes associated with 2 LDI protocols of buprenorphine among individuals with opioid use disorder (OUD) using fentanyl.
Peripheral Nerve Block Combined with Low-Dose General Anaesthesia in Elderly Patients Receiving Hip Arthroplasty.
J Coll Physicians Surg Pak
January 2025
Department of Anaesthesiology, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing, China.
The study assessed the effectiveness and safety of nerve block combined with low-dose general anaesthesia in elderly hip arthroplasty patients, conducted by a meta-analysis of RCTs. Six trials involving 403 patients were identified from databases such as Cochrane, MEDLINE, and PubMed. The results demonstrated a statistically significant difference in pain scores at postoperative 12hours (95% CI, -2.
View Article and Find Full Text PDFManaging Dual Dependencies: A Case Study of Concurrent Low-Dose Buprenorphine Induction and Rapid Phenobarbital Taper.
J Psychoactive Drugs
January 2025
McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Co-occurring substance use disorders are common in medical settings, yet limited literature exists on concomitant pharmacological management. We present a case where low-dose buprenorphine induction (LDBI) and rapid phenobarbital taper were performed concurrently in a hospital setting to manage co-occurring opioid dependence (on chronic methadone maintenance therapy) and benzodiazepine dependence (prescribed alprazolam). The simultaneous management was well-tolerated and completed with minimal complications, successfully enabling candidacy for the patient's preferred disposition.
View Article and Find Full Text PDFTAK-925 (danavorexton), an Orexin Receptor 2 Agonist, Reduces Opioid-Induced Respiratory Depression and Sedation Without Affecting Analgesia in Healthy Adult Males.
Anesthesiology
January 2025
Takeda Development Center Americas, Inc., Lexington, MA, USA.
Background: Orexin neuropeptides help regulate sleep/wake states, respiration, and pain. However, their potential role in regulating breathing, particularly in perioperative settings, is not well understood. TAK-925 (danavorexton), a novel, orexin receptor 2-selective agonist, directly activates neurons associated with respiratory control in the brain and improves respiratory parameters in rodents undergoing fentanyl-induced sedation.
View Article and Find Full Text PDFLow-dose naltrexone as a treatment for vulvodynia: A case series.
Case Rep Womens Health
March 2025
Division of Minimally Invasive Gynecology Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 460 Waterstone Drive, Hillsborough, NC 27278, USA.
Vulvodynia is a chronic vulvar pain condition that can be challenging to treat and often requires multi-modal interventions for symptom management. Low-dose naltrexone (LDN) is a reversible competitive antagonist at opioid receptors and may have utility in treating chronic pain conditions. In a specialty gynecology clinic at an academic medical center, patients with poorly controlled vulvodynia who had failed standard treatments were offered LDN as an adjunct pain treatment.
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