Implantes de naltrexona: un avance terapéutico, tanto comportamental como farmacológico

Colin Brewer, Emmanuel Streel


A principios de los setenta, los pioneros del tratamiento con naltrexona (NTX) comprendieron que un implante o inyección depot de NTX ayudaría a eliminar el bajo seguimiento del tratamiento. Los primeros estudios en animales sobre formulaciones implantables aparecieron a mediados de los setenta, y los estudios en humanos pronto demostraron que los niveles efectivos de NTX en plasma podían mantenerse varias semanas con formulaciones implantables estándar. Pero sólo en los últimos años han podido emplearse implantes y depots para uso clínico. Un número creciente de artículos describen su efectividad en la prevención de recaídas, incluyendo casos de médicos y embarazadas adictos y adolescentes problemáticos que consumen frecuentemente sobredosis de opiáceos. Los niveles típicos de NTX en plasma derivados de los implantes pueden bloquear completamente los efectos de los opiáceos de hasta 500 mg de heroína farmacológica durante más de seis meses. Incluso los implantes de “primera generación”, de más corto efecto, reducen considerablemente los elevados índices de temprana reincidencia comunes tras una desintoxicación de opiáceos. Los depots de NTX tienen también potencial en los tratamientos del alcoholismo. Pero la naturaleza farmacológica de los implantes de NTX no debe ocultar que también facilitan y refuerzan importantes procesos psicológicos cruciales en el éxito a largo plazo de los tratamientos de adicción. El desarrollo de agentes bloqueadores de larga duración para otras drogas de consumo significa que los nuevos principios de los tratamientos con implantes de NTX podrán aplicarse pronto a problemas relacionados con benzodiacepinas, estimulantes y cannabis. Recomendamos el término “abstinencia antagonista-asistida” para este enfoque, pero insistimos en que los tratamientos de mantenimiento siguen ocupando un importante lugar.

Palabras clave

Naltrexona; implantes; depots; heroína; antagonista; abstinencia; tratamiento

Texto completo:



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