"How effective a medication is can be dependent on its mode of delivery"

Oral Naltrexone vs Extended-Release Injectable Suspension: Is there a difference?

Medications can be adminsitered to the body using multiple different modalities.  For example, the commonly used atypical anti-psychotic medication olanzepine can be given in oral form (tablets), via intramuscular injection with a short-acting formulation, or via an intramuscular injection with a long-acting formulation that is given every 2 to 4 weeks.  Some practitioners also adminsitered the short-acting formulation intra-venously as an off-label alternative.  These varioius routes of adminsitration offer clinicans and patients different advantages (and disadvantages) of treatment.  

The opioid receptor-blocking medication naltrexone (with its close chemical cousin naloxone) can also be administered via multiple routes including orally, intra-muscularly (naloxone - short-acting), intra-muscularly (naltrexone - long-acting), sub-cutaneous implants (naltrexone), intra-venously (naloxone), and intra-nasally (naloxone). 

One recently published study titled, "A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder," demonstrated that the use of the injectable, long-acting formulaton of naltrexone "had twice the rate of treatment retention at 6 months compared with those taking oral naltrexone.  This difference is largely attributed to the poor adherence rates with oral naltrexone which in some studies range from 9% to 22% at 24 weeks of treament.  In this study, 57% of the naltrexone XR (long-acting injection) group stayed in treatment at 6 months whereas only 28% of the oral naltrexone group were retained.  

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TelePsychiatry Associates, LLC specialized in the remote delivery of psychiatric care to patients who cannot easily access care or who prefer the privacy and convenience of care provided using advanced technologies.  Our practitioners are skilled in the diagnosis and treatment of a wide variety of different conditions including: depression, bipolar affective disorder, alcohol use disorders, opiate dependence, substance detoxification, substance withdrawal management, anxiety disorders, post-traumatic stress disorder, trauma related to sexual or physical abuse, and weight loss management, among others.  

The types of treatments provided will depend upon your practitioner and the problems needing attention.  Whether in-office treatment or tele-health technology is employed depends on a number of factors including patient preferenence, location, and type and severity of the condition.  After a short consultation, we will be able to determine the best fit for you and your provider.  

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