Clinical Study The Therapeutic Effect of Adding Dextromethorphan to Clonidine for Reducing Symptoms of Opioid Withdrawal: A Randomized Clinical Trial

Background. Dextromethorphan is a noncompetitive N-methyl D-aspartate receptor antagonist that is clinically feasible for relieving the opioid withdrawal symptoms. )is study compares the e*cacy of a combination therapy with dextromethorphan and clonidine to treatment with clonidine alone. Methods and Materials. In this double-blind randomized clinical trial, patients were selected from inpatients of detox and rehabilitation ward of Razi Hospital, Tabriz, Iran.)ey were randomly allocated to two groups receiving either clonidine (0.4–1.2mg/day) or clonidine and dextromethorphan (300mg/day). Withdrawal symptoms were evaluated in the +rst day of admission and again 24, 48, and 72 hours later. Results.)irty male patients completed the trial in each group. Withdrawal symptoms began to decrease in the second day in patients receiving dextromethorphan and clonidine while patients receiving clonidine experienced the more severe symptoms in 72 hours. Analysis of variance of the symptom severity score revealed a signi+cant group × time interaction (" = 14.25; # < 0.001), so that patients receiving dextromethorphan plus clonidine hadmilder symptoms during three days in all of themeasurements compared to clonidine group.Conclusion. Combination therapy of dextromethorphan and clonidine would result in milder opioid withdrawal symptoms compared to clonidine alone with a reduction beginning at the second day.