Key result
Opioid antagonists show no consistent benefit for functional recovery following ischemic stroke.
Why the study?
Stroke is a leading cause of death and disability requiring novel neuroprotective treatments, and there is increased interest in the relationship between opioids and ischemic stroke.
Do opioid antagonists (naloxone and nalmefene) improve recovery and functional status in patients with ischemic stroke?
Systematic Review
Do opioid antagonists (naloxone and nalmefene) improve recovery and functional status in patients with ischemic stroke?
Current evidence from clinical trials does not consistently support the effectiveness of opioid antagonists like naloxone and nalmefene for ischemic stroke, indicating a need for larger, better-targeted trials.
Lacks support for opioid antagonists in ischemic stroke; leaves open targeted efficacy pending larger trials.
Stroke is a leading cause of death and disability, and novel treatments need to be found, particularly drugs with neuroprotective and restorative effects. Lately, there has been an increased interest in the relationship between opioids and ischemic stroke. To further appreciate this association between opioids and stroke, we conducted a systematic review to investigate anti-opioid medication's effectiveness in treating ischemic stroke. We used PubMed advanced-strategy and Google Scholar searches and only included full-text clinical trials on humans and written in the English language. After applying the inclusion/exclusion criteria, seven clinical trials were reviewed. Only one of the naloxone and nalmefene clinical trials showed statistically favorable results. Overall, the nalmefene clinical trials used more updated measures (NIHSS, GOS) to evaluate recovery and functional status in ischemic stroke patients than the naloxone clinical trials. There was less bias in the nalmefene clinical trials. Animal and in vitro studies have showed promising results. Additional research should be conducted with new clinical trials of both drugs with larger samples in patients less than 70 years old and moderate to severe infarcts.
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Ortíz et al. (2021) conducted a systematic review in Ischemic stroke. Opioid antagonists (naloxone and nalmefene) was evaluated on Recovery and functional status. A systematic review of seven clinical trials evaluating opioid antagonists (naloxone and nalmefene) for ischemic stroke found that only one trial showed statistically favorable results.
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