Demographic and Clinical Characteristics of 907 Cases with Naltrexone Intoxication; a 14-Year Cross-Sectional Study

Opioids have been the leading cause of death from poisoning in Iran for several years. This studyaimed to evaluate the clinical and para-clinical presentations of naltrexone intoxication, its toxic dose, andits epidemiological properties.

This retrospective cross-sectional study was conducted on medicalrecords of patients presenting to Toxicology Department of Loghman Hakim Hospital, Tehran, Iran, followingnaltrexone intoxication, from 2002 to 2016. Patients’ demographic and laboratory data, clinical signs, supposedingested dose, and intent of naltrexone consumption were collected, analyzed, and then interpreted.

907 patients with the mean age of 36.6 ±11.7 years were evaluated (94.3% male). The mean amount of naltrex-one consumed by the intoxicated patients reported in the medical records was 105.8 ± 267.8 mg. One hundredthirty patients (14.3%) used naltrexone to treat substance use disorder. Two hundred eighty-seven poisoned pa-tients (31.6%) were current opium users who intentionally or unintentionally used naltrexone concomitantly.The most common symptoms observed in these patients were agitation (41.8%), vomiting (16.4%), and nau-sea (14.8%). Among patients with naltrexone poisoning, 25 patients were intubated (2.8%), and three passedaway. Aspartate aminotransferase (AST) levels were significantly higher in patients intoxicated with naltrexonewho needed intubation (p = 0.02).

The probability of intubation of cases with naltrexone intoxica-tion was associated with AST elevation. It seems that, the number of intensive care unit (ICU) admissions andmortality rates are not high among these patients.